ANESTHETIC DRUG SELECTION AND ITS INFLUENCE ON POST-SURGICAL RECOVERY TIME: A MULTICENTER ANALYSIS

Abstract

Postoperative recovery time refers to the duration required for a patient to regain baseline physiological function and readiness for discharge following anesthesia and surgery. It is a critical outcome metric that influences patient safety, satisfaction, and healthcare resource utilization. This multicenter observational study evaluated the impact of anesthetic drug selection on postoperative recovery profiles in adult patients undergoing elective surgical procedures under general anesthesia. A total of 750 patients aged 18 to 65 years with ASA physical status I–III were enrolled across five tertiary-care hospitals. Patients were categorized into five groups based on the primary maintenance anesthetic agent: propofol (TIVA), sevoflurane, desflurane, esketamine, or esketamine combined with dexmedetomidine. Recovery outcomes included time to spontaneous respiration, eye opening, Aldrete score ≥9, PACU discharge time, and hospital stay duration. Secondary measures included postoperative nausea and vomiting (PONV), delayed emergence, opioid use within 24 hours, and emergence delirium. The esketamine–dexmedetomidine group demonstrated the most favorable recovery profile, with the shortest PACU discharge time (34.7 ± 6.2 minutes), lowest opioid requirements, and minimal incidence of emergence delirium (1.0%). Propofol-based TIVA also outperformed volatile anesthetics across primary endpoints. In contrast, sevoflurane and desflurane were associated with longer recovery and higher PONV rates. Multivariate regression confirmed anesthetic regimen as an independent predictor of recovery time. These findings support the integration of NMDA-antagonist-based and intravenous anesthetic strategies into enhanced recovery protocols for optimized postoperative outcomes.