Abstract
BackgroundStudies have described different recovery profiles of sevoflurane and desflurane typically early after surgery.MethodsWe conducted a randomized superiority trial to determine whether Overall Recovery 3 days after knee arthroscopy would be superior with desflurane. Adult participants undergoing knee arthroscopic surgery with general anesthesia were randomized to either desflurane or sevoflurane general anesthesia. Intraoperative and postoperative drugs and analgesics were administered at the discretion of the anesthesiologist. Postoperative quality of recovery was assessed using the “Postoperative Quality of Recovery Scale”. The primary outcome was Overall Recovery 3 days after surgery and secondary outcomes were individual recovery domains at 15 minutes, 40 minutes, 1 day, 3 days, 1 month, and 3 months. Patients and researchers were blinded.Results300 patients were randomized to sevoflurane or desflurane (age 51.7±14.1 vs. 47.3±13.5 years; duration of anesthesia 24.9±11.1 vs. 23.3±8.3 minutes). The proportion achieving baseline or better scores in all domains increased over the follow-up period in both groups but was not different at day 3 (sevoflurane 43% vs. desflurane 37%, p = 0.314). Similarly, rates of recovery increased over time in the five subdomains, with no differences between groups for physiological, p = 0.222; nociceptive, p = 0.391; emotive, p = 0.30; Activities-of-daily-living, p = 0.593; and cognitive recovery, p = 0.877.ConclusionNo significant difference in the quality of recovery scale could be shown using sevoflurane or desflurane general anesthesia after knee arthroscopy in adult participants.
Highlights
Knee arthroscopy is a commonly performed outpatient surgical procedure
No significant difference in the quality of recovery scale could be shown using sevoflurane or desflurane general anesthesia after knee arthroscopy in adult participants
Inhalational anesthetics are often used as they enable rapid emergence from anesthesia with minimal postoperative side effects.[1]
Summary
Knee arthroscopy is a commonly performed outpatient surgical procedure. Inhalational anesthetics are often used as they enable rapid emergence from anesthesia with minimal postoperative side effects.[1]The most frequently used inhalational anesthetics are sevoflurane and desflurane, which differ in their pharmacokinetic properties and could have different effects on postoperative quality of recovery.[2,3,4,5,6,7,8] Comparative studies have shown that desflurane is superior to sevoflurane in terms of early recovery parameters such as return of pharyngeal reflexes and wakefulness,[2,3,4, 6,7,8] and it has been demonstrated that sevoflurane has considerable variability in these physiological parameters, leading to less predictable recovery times than desflurane.[2, 3] the perioperative incidence of coughing has been found higher with desflurane than with sevoflurane.[6]. Knee arthroscopy is a commonly performed outpatient surgical procedure. Inhalational anesthetics are often used as they enable rapid emergence from anesthesia with minimal postoperative side effects.[1]. The most frequently used inhalational anesthetics are sevoflurane and desflurane, which differ in their pharmacokinetic properties and could have different effects on postoperative quality of recovery.[2,3,4,5,6,7,8] Comparative studies have shown that desflurane is superior to sevoflurane in terms of early recovery parameters such as return of pharyngeal reflexes and wakefulness,[2,3,4, 6,7,8] and it has been demonstrated that sevoflurane has considerable variability in these physiological parameters, leading to less predictable recovery times than desflurane.[2, 3] the perioperative incidence of coughing has been found higher with desflurane than with sevoflurane.[6] several studies have described different recovery profiles of sevoflurane and desflurane, physiological recovery parameters have typically been the main focus. Studies have described different recovery profiles of sevoflurane and desflurane typically early after surgery
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