Abstract
We compared the effect of desflurane and sevoflurane on anesthesia recovery time in patients undergoing urological cystoscopic surgery. The Short Orientation-Memory-Concentration Test (SOMCT) measured and compared cognitive impairment between groups and coughing was assessed throughout the anesthetic. This investigation included 75 ambulatory patients. Patients were randomized to receive either desflurane or sevoflurane. Inhalational anesthetics were discontinued after removal of the cystoscope and once repositioning of the patient was final. Coughing assessment and awakening time from anesthesia were assessed by a blinded observer. Statistical analysis was performed by using t-test for parametric variables and Mann-Whitney U test for non-parametric variables. The primary endpoint, mean time to eye-opening, was 5.0 ± 2.5 min for desflurane and 7.9 ± 4.1 min for sevoflurane (p < 0.001). There were no significant differences in time to SOMCT recovery (p = 0.109), overall time spent in the post-anesthesia care unit (PACU) (p = 0.924) or time to discharge (p = 0.363). Median time until readiness for discharge was 9 min in the desflurane group, while the sevoflurane group had a median time of 20 min (p = 0.020). The overall incidence of coughing during the perioperative period was significantly higher in the desflurane (p = 0.030). We re-confirmed that patients receiving desflurane had a faster emergence and met the criteria to be discharged from the PACU earlier. No difference was found in time to return to baseline cognition between desflurane and sevoflurane.
Highlights
Desflurane and sevoflurane are the two most commonly administered inhaled anesthetics for outpatient surgeries due to their favorable pharmacokinetic profiles and low incidence of untoward effects
Multiple studies have demonstrated that desflurane allows for a more rapid emergence than sevoflurane, and this may be beneficial for outpatient surgery, where quick case turnover and reduced post-anesthesia care unit (PACU) time is essential to ensure a good workflow [2, 3]
Our primary objective was to compare the effect of desflurane and sevoflurane on anesthesia recovery time in patients undergoing urological cystoscopic surgery under general anesthesia using a laryngeal mask airway (LMA)
Summary
Desflurane and sevoflurane are the two most commonly administered inhaled anesthetics for outpatient surgeries due to their favorable pharmacokinetic profiles and low incidence of untoward effects. Both of these agents have been safely used for anesthesia maintenance using a laryngeal mask airway (LMA) [1,2,3,4]. Our primary objective was to compare the effect of desflurane and sevoflurane on anesthesia recovery time in patients undergoing urological cystoscopic surgery under general anesthesia using a LMA. In order to accomplish this, we modified our anesthesia protocol to maintain stable end-tidal anesthetic concentrations and administer intravenous (IV) fentanyl on induction
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have