Abstract:Objective To compare the effects of total intravenous anesthesia (TIVA) and inhalation anesthesia on early postoperative recovery quality, adverse events and postoperative deliriurn in patients with pulmonary tuberculosis undergoing argon plasma coagulation (APC). Methods A total of 90 pulmonary tuberculosis patients who underwent APC at Second Hospital of Nanjing from September 1st, 2022, to September 30th, 2024, were prospectively selected. The patients were randomly divided into Group T and Group I, with 45 patients in each group. In the Group T, propofol-based TIVA and routine medications were used for anesthesia induction, while in the Group I, sevoflurane-based inhalation anesthesia and routine medications were used. The following parameters were recorded: general data, surgery duration, anesthesia duration, extubation time, time to leave the operating room, fluid replacement volume, vital signs, intraoperative adverse events, and cough intensity during extubation. Postoperative recovery was assessed over the first 7 days, including pain [using the Visual Analog Scale (VAS)], nausea and vomiting, dizziness, recovery quality [using the 15-item Quality of Recovery (QoR-15) scale], and the occurrence of delirium [using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU)]. Results There was a significant time effect on mean arterial pressure (MAP), heart rate, and saturation of peripheral oxygen (SpO₂) in both groups (P<0.05), but no significant group effect or interaction effect was observed (P>0.05). Pairwise comparisons showed that MAP decreased after induction in both groups (P<0.05). Heart rate was lower in Group T than in Group I when leaving the operating room, and heart rate decreased intraoperatively in both groups (P<0.05), but heart rate in Group I before anesthesia exceeded that when leaving the operating room (P<0.05); SpO₂ increased after induction but was lower before anesthesia than that when leaving the operating room (P<0.05). There was no significant difference in the incidence of hypotension, hypertension, hypoxemia, or bradycardia between the two groups (P>0.05), but the incidence rates of tachycardia were lower in Group T than that in Group I (15.56% vs 62.22%, χ²=20.618, P<0.01). There was no significant difference in cough intensity at extubation between the two groups (Z=1.567, P=0.117). There was no significant difference in VAS and QoR-15 scores between the two groups (P>0.05). Compared with preoperative day 1, both groups had decreased QoR-15 scores on postoperative day 1 and day 2 (P<0.05). There was no significant difference in the incidence of delirium on postoperative day 1 between Group I and Group T (11.11% vs 8.89%, χ²=0.123, P= 0.725). The incidence of dizziness in Group T was significantly lower than that in Group I at 4 hours postoperatively (P< 0.05). Similarly, the incidences of nausea and vomiting were significantly lower in Group T compared to Group I at 2, 4, and 6 hours postoperatively (P<0.05). Conclusion In pulmonary tuberculosis patients undergoing APC, TIVA showed more stable blood pressure and heart rate control compared to inhalation anesthesia, as well as a lower incidence of nausea, vomiting, and dizziness.