Comparative Study Between Desflurane and Sevoflurane Regarding Haemodynamics and Recovery Profiles in Obese Patients Undergoing Laparoscopic Sleeve Gastrectomy

Abstract

ABSTRACT Background Enhanced recovery after bariatric surgeries and resumption of complicated physiological functions are properties of ideal anaesthetic. The goal of the current study was to compare the effects of desflurane and sevoflurane on intra-operative haemodynamics and recovery profiles in obese individuals undergoing laparoscopic sleeve gastrectomy. Settings and Design Prospective randomized controlled trial. Methods After Local Ethical Committee approval, 50 obese patients, between ages 20 and 40, undergoing elective LSG were randomly assigned to receive desflurane (group D) or sevoflurane (group S). Entropy value was maintained between 40 and 60. Haemodynamic parameters including cardiac index (CI) were recorded. Minimum alveolar concentration that maintained target entropy (MACEN) values were calculated immediately after intubation and every 30 minutes until the end of procedure. After weaning from anaesthesia, time to fully awake entropy values and immediate recovery parameters were recorded. In post anaesthesia care unit (PACU), intermediate recovery was assessed using Modified Aldrete’s Score (MAS) and Digit Symbol Substitution Test (DSST).The duration of PACU stay was documented. Results Intra-operative haemodynamic parameters were comparable between two groups. The mean MACEN values for D group were significantly higher than S group immediately after intubation; however, they were significantly less than S group during the whole intra-operative period. Post-operatively, time to reach fully awake entropy values and immediate recovery parameters were shorter in group D than in group S. Desflurane anaesthetized patients had higher MAS than sevoflurane patients upon arrival at PACU and after 5 minutes. DSST restored to baseline values more quickly after desflurane anaesthesia. In comparison to group S, group D’s PACU stay was shorter. Conclusions Desflurane and sevoflurane both had similar haemodynamic parameters; however, the recovery profiles were significantly quicker after desflurane anaesthesia enabling fast-tracking and patients to be early discharged.