Abstract
BackgroundThis study aimed to determine whether the use of desflurane (DES) anesthesia combined with bispectral index (BIS) monitoring and warming is effective in reducing anesthesia-controlled operating room time (ACT) in patients undergoing lengthy abdominal surgery.MethodsSeventy patients, 40 years of age or older, undergoing abdominal surgery expected to last three to five hours were randomly assigned to the DES group (n = 35) or the control group (n = 35). Patients in the DES group were maintained with desflurane anesthesia and received BIS monitoring and warming. Patients in the control group were given non-desflurane anesthesia for maintenance, and the usage of BIS monitoring and warming were not mandatory and determined by anesthesia care providers. Early postoperative recovery times were recorded.ResultsThe times to extubation (8.8 ± 8.5 vs 14.7 ± 13.7 min, P = 0.035), eye opening (8.4 ± 8.6 vs 14.4 ± 13.4 min, P = 0.028), responds on command (8.2 ± 8.5 vs 14.4 ± 13.0 min, P = 0.022), and the ACT (23.8 ± 11.4 vs 32.7 ± 15.4 min, P = 0.009) were significantly less in the DES group than that in the control group. The postanesthesia care unit (PACU) length of stay, incidence of prolonged extubation, and surgeon and anesthesiologist satisfaction were similar in two groups. Also, the result of multivariable linear regressions showed that patients who were younger, female, lower BMI and non-DES anesthesia regimen resulted in prolonged extubation.ConclusionsDesflurane anesthesia combined with BIS monitoring and warming is associated with early postoperative recovery in lengthy abdominal surgery.Trial registrationChiCTR-INR-17013333. Date of registration: November 11, 2017.
Highlights
This study aimed to determine whether the use of desflurane (DES) anesthesia combined with bispectral index (BIS) monitoring and warming is effective in reducing anesthesia-controlled operating room time (ACT) in patients undergoing lengthy abdominal surgery
Considering the multiple factors affecting the early extubation, the aim of this study was to explore whether desflurane-based anesthesia combined with BIS monitoring and active warming in lengthy abdominal surgery could reduce the extubation time, improve the quality of post-anesthesia recovery, and satisfaction of surgeons and operating room (OR) members
We investigated the effects of desflurane-based anesthesia regimen including BIS monitoring and warming on early postoperative recovery in lengthy abdominal surgery
Summary
This study aimed to determine whether the use of desflurane (DES) anesthesia combined with bispectral index (BIS) monitoring and warming is effective in reducing anesthesia-controlled operating room time (ACT) in patients undergoing lengthy abdominal surgery. Anesthesia-controlled time (ACT) and turnover time are two of the most important factors that regulate operating room (OR) efficiency [1]. Prolonged extubation is an important factor affecting operating room efficiency, which is a concern of surgeons and anesthesia care providers [2, 3]. Choosing appropriate anesthetic agents or techniques is essential for anesthesia care providers to reduce time of extubation and post-anesthesia recovery. Desflurane reduced the mean time to extubation and time to follow commands by 21% and 23%, respectively [2]. The time of emergence and extubation between propofol-based total intravenous anesthesia (TIVA) via target-controlled infusion (TCI) system and desflurane are controversial [6]
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