A comparative study of desflurane/fentanyl with sevoflurane/fentanyl on time of awakening and airway morbidity in ambulatory surgery using a supraglottic airway device: A randomized, single-blind study

Abstract

Background and Aims: The goal of anesthesia for ambulatory surgeries is rapid recovery with decreased hospital stay for rapid turnover of patients. We aim to compare desflurane and sevoflurane with regard to their recovery profile and incidence of airway morbidity and to study the effect of opioid (fentanyl) on these study parameters. Methods: We randomized seventy American Society of Anesthesiologists physical status I and II patients, aged 18–60 years of either sex undergoing elective surgery of less than an hour duration into two groups: Group D (desflurane + fentanyl) and Group S (sevoflurane + fentanyl). After standard induction of anesthesia, Proseal™ laryngeal mask airway was inserted. Intravenous fentanyl was administered based on entropy values. Anesthesia was maintained on a group-specific inhalational agent. We recorded the time taken for eye opening, follow commands, vocalize, attain modified Aldrete score ≥9 in postanesthesia care unit (PACU), incidence of airway morbidity, rescue analgesic requirement in 1st h postoperatively, and any other complication. Results: The mean time to awakening was significantly faster in Group D (P < 0.001) with shorter stay in PACU (P < 0.001). Incidence of airway morbidity was higher in Group D than Group S, but was not statistically significant (P = 0.710). Conclusion: Desflurane provides faster recovery with shorter PACU stay compared to sevoflurane with comparable incidence of airway morbidity. Opioids may affect airway morbidity, but must be used judiciously to avoid its unwanted effect on recovery.