| Abstract:Objective：To compare the efficacy and safety between propofol and sevoflurane in free flap breast reconstruction. Methods：The data of patients, who underwent free flap breast reconstruction with propofol (P group, n=16) or sevoflurane (S group, n=19), were collected. Postoperative complications of flap, postoperative nausea and vomiting （PONV） and intraoperative mean arterial blood pressure were retrospectively analyzed. Results：No statistical significance of the baseline patient characteristics, duration of surgery and anesthesia was found between the two groups. The incidence of flap compromise was 6.3％in the P group while it was 10.5％ in the S group. No statistical significance of the history of PONV, motion sickness and smoking was found between two groups. Also no statistical significance of intraoperative sufentanil and remifentanil administered, postoperative PCIA consumption was found between the two groups. The incidence of nausea (from 0 to 2 h) was significantly decreased in the P group (18.8% vs 68.4%, P=0.003). The incidences of vomiting (from 2 to 6 h, 0 to 24 h) were significantly reduced in the P group (18.8% vs 52.6%, P=0.039; 18.8% vs 57.9%, P= 0.019). No statistical significance of preoperative mean arterial blood pressures was found between two groups （［88.06±6.86］ mmHg vs ［88.10±8.13］ mmHg，P＝0.987）. Significant decreases in intraoperative mean arterial blood pressures compared with preoperative mean arterial blood pressures were observed in both groups（P＜0.05）. Intraoperative mean arterial blood pressure was lower in the S group compared with the P group(P＜0.05). More ephedrine was used in the S group (P＜0.05). There was no intraoperative awareness in both groups. There were no significant differences in extubation time and 24 h quality of recovery score between the two groups. Conclusions：There was no difference in the outcome of flap between propofol and sevoflurane. Compared with sevoflurane, propofol improves postoperative nausea and vomiting with less intervention in mean arterial blood pressure. |