Comparative study of Intraoperative Haemodynamics and recovery characteristics of desflurane and sevoflurane in patients receiving General Anaesthesia

Abstract

Background: Inhaled anesthetics used for general anaesthesia have a rapid onset and offset of action. The Induction and recovery depends on anaesthetic drug solubility, cardiac output and minute ventilation. Sevoflurane and desflurane have low blood gas partition coefficients, and therefore share the advantage of faster onset and recovery from anaesthesia when compared to other inhaled anesthetics. Hence, we designed this prospective randomized study to compare the intraoperative haemodynamic parameters and recovery characteristics of desflurane and sevoflurane. Methods: Sixty patients aged between 18-50 years belonging to ASA I and II scheduled for elective general anaesthesia were enrolled in the study and randomly divided into two groups to receive desflurane(group D) and sevoflurane(group S) for the maintenance of anaesthesia. Both groups were premedicated, pre oxygenated and induced with propofol. Muscle relaxation maintained with vecuronium. Desflurane and sevoflurane concentrations were adjusted according to entropy parameters and clinical variables like HR, NIBP, MAP and SPO2. Neuromuscular blockade reversed with neostigmine and glycopyrrolate. Recovery characteristics assessed using modified Aldrete scoring. Results: The intraoperative haemodynamics was similar with both desflurane and sevoflurane, and was maintained within 20% of baseline values. However, early recovery characteristics were significantly better in group D. Time to eye opening was 6.63 + 2.17 min in group S versus 4.77 + 1.41 min in group D (P< 0.001). Time to Extubation was 8.03 + 2.54 min in group S and 5.93 + 1.44 min in group D (P < 0.001). Response to verbal commands was 8.77 + 3.01 min in group S and 6.97 + 1.67 min in group D (P < 0.001). Modified Aldrete score were significantly better in group D than group S at 1st min, 2nd min and 3rd min. Thereafter, modified Aldrete score assessed at 5, 10, 15, 30 and 60 min were similar in both groups. Conclusion: Both desflurane and sevoflurane produce similar stable haemodynamic profile. Despite the faster early recovery with desflurane, no significant differences were found between the two volatile anaesthetics after 5 minutes during intermediate recovery period.