Comparison of maintenance and emergence characteristics after desflurane or sevoflurane in outpatient anaesthesia

Ravi Jindal, Ved Prakash Kumra, Krishan Kumar Narani, Jayashree Sood, Ravi Jindal, Ved Prakash Kumra, Krishan Kumar Narani, Jayashree Sood

Abstract

Both sevoflurane and desflurane have shorter emergence times compared to isoflurane based anaesthesia. Because of its pharmacological properties, desflurane appears to yield a rapid early and intermediate recovery compared with sevoflurane. The aim of this study was to assess the maintenance and emergence characteristics after anaesthesia with sevoflurane or desflurane. One hundred female patients scheduled to undergo daycare laparoscopic gynaecological surgery were enrolled for this prospective study. Patients were randomised into two groups to receive either desflurane [group I (D); n = 50] or sevoflurane [group II (S); n = 50] for maintenance of anaesthesia. The demographic data and the duration of procedure were comparable in both the groups. The early recovery time was shorter after maintenance of anaesthesia with desflurane compared with sevoflurane. However, this faster early recovery failed to lead to early readiness for home discharge. The intraoperative haemodynamic characteristics were comparable with both sevoflurane and desflurane. Both sevoflurane and desflurane provide a similar time to home readiness despite a faster early recovery with desflurane. The intraoperative haemodynamics are similar with both the agents.

Keywords: Desflurane; outpatient; recovery; sevoflurane.

Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Comparison of heart rate
Figure 2
Figure 2
Comparison of mean arterial pressure

References

    1. Gupta A, Stierer T, Zuckerman R, Sakima N, Parker SD, Fleisher LA. Comparison of recovery profile after ambulatory anesthesia with propofol, isoflurane, sevoflurane and desflurane: A systematic review. Anesth Analg. 2004;98:632–41.
    1. Eriksson LI. The effects of residual neuromuscular blockade and volatile anesthetics on control of ventilation. Anesth Analg. 1999;89:243–51.
    1. Nathanson MH, Fredman B, Smith I, White PF. Sevoflurane versus desflurane for outpatient anaesthesia: A comparison of maintenance and recovery profiles. Anesth Analg. 1995;81:1186–90.
    1. Eberts TJ, Schmid PG. Inhaled anesthetics. In: Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, editors. Clinical Anesthesia. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2009. pp. 413–43.
    1. Morgan GE, Jr, Mikhail MS, Murray MJ. Clinical Anesthesiology. 4th ed. New York: McGraw-Hill; 2006. Inhalational anesthetics; pp. 155–78.
    1. Sjosvard NK, Sjoberg F, Gupta A. Anaesthesia for videoarthroscopy of the knee. A comparison between desflurane and sevoflurane. Acta Anaesth Scand. 1998;42:464–71.
    1. Karlsen KL, Persson E, Wennberg E. Anaesthesia, recovery and postoperative nausea and vomiting after breast surgery. A comparison between desflurane, sevoflurane and isoflurane anaesthesia. Acta Anaesth Scand. 2000;44:489–93.
    1. Dupont J, Tavernier B, Ghosez Y, Durinck L, Thevenot A, Moktadir-Chalons N, et al. Recovery after anaesthesia for pulmonary surgery: Desflurane, sevoflurane and isoflurane. Br J Anaesth. 1999;82:355–9.
    1. Welborn LG, Hannallah RS, Norden JM, Ruttimann UE, Callan CM. Comparison of emergence and recovery characteristics of sevoflurane, desflurane and halothane in pediatric ambulatory patients. Anesth Analg. 1996;83:917–20.
    1. Mahmoud NA, Rose JA, Laurence AS. Desflurane or sevoflurane for gynaecological day case anaesthesia with spontaneous respiration. Anaesthesia. 2001;56:171–4.
    1. Isik Y, Goksu S, Kocoglu H, Oner U. Low flow desflurane and sevoflurane anaesthesia in children. Eur J Anaesthesiol. 2006;23:60–4.
    1. Eger EI, 2nd, Gong D, Koblin DD, Bowland T, Ionescu P, Laster MJ, et al. The effect of anesthetic duration on kinetic and recovery characteristics of desflurane versus sevoflurane, and on the kinetic characteristics of compound A, in volunteers. Anesth Analg. 1998;86:414–21.
    1. Juvin P, Servin F, Giraud O, Desmonts JM. Emergence of elderly patients from prolonged desflurane, isoflurane, or propofol anaesthesia. Anesth Analg. 1997;85:647–51.
    1. Heavner JE, Kaye AD, Lin BK, King T. Recovery of elderly patients from two or more hours of desflurane or sevoflurane anaesthesia. Br J Anaesth. 2003;91:502–6.
    1. Rörtgen D, Kloos J, Fries M, Grottke O, Rex S, Rossaint R, et al. Comparison of early cognitive function and recovery after desflurane or sevoflurane anaesthesia in the elderly: A double-blinded randomized controlled trial. Br J Anaesth. 2010;104:167–74.
    1. Dexter F, Bayman EO, Epstein RH. Statistical modeling of average and variability of time to extubation for meta-analysis comparing desflurane to sevoflurane. Anesth Analg. 2010;110:570–80.
    1. Bedforth NM, Hardman JG, Nathanson MH. Cerebral haemodynamic response to the introduction of desflurane: A comparison with sevoflurane. Anesth Analg. 2000;91:152–5.
    1. Ebert TJ, Muzi M, Lopatka CW. Neurocirculatory responses to sevoflurane in humans: A comparison to desflurane. Anesthesiology. 1995;83:88–95.
    1. Goff MJ, Arain SR, Ficke DJ, Uhrich TD, Ebert TJ. Absence of bronchodilation during desflurane anesthesia-A comparison to sevoflurane and thiopental. Anesthesiology. 2000;93:404–8.
    1. TerRiet MF, DeSouza GJ, Jacobs JS, Young D, Lewis MC, Herrington C, et al. Which is most pungent: Isoflurane, sevoflurane or desflurane? Br J Anaesth. 2000;85:305–7.
    1. Klock PA, Jr, Czeslick EG, Klafta JM, Ovassapian A, Moss J. The effect of sevoflurane or desflurane on upper airway reactivity. Anesthesiology. 2001;94:963–7.
    1. Eshima RW, Maurer A, King T, Lin BK, Heavner JE, Bogetz MS, et al. A comparison of airway responses during desflurane and sevoflurane administration via a laryngeal mask airway for maintenance anesthesia. Anesth Analg. 2003;96:701–5.
    1. McKay RE, Large MJ, Balea MC, McKay WR. Airway reflexes return more rapidly after desflurane anesthesia than after sevoflurane anesthesia. Anesth Analg. 2005;100:697–700.
    1. McKay RE, Bostrom A, Balea MC, McKay WR. Airway responses during desflurane versus sevoflurane administration via a laryngeal mask airway in smokers. Anesth Analg. 2006;103:1147–54.

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