Recovery Profile After General Anaesthesia in Paediatric Ambulatory Surgeries: Desflurane Versus Propofol.

Abstract

Paediatric ambulatory surgeries warrant a speedy recovery of patients without compromising their safety. Short-acting agents such as propofol and desflurane help facilitate these objectives. In this prospective, randomised study we compared the recovery profile in paediatric patients undergoing ambulatory surgeries who received entropy guided general anaesthesia (GA) using desflurane and propofol as maintenance anaesthetics. We enrolled 80 children (3-10 years of age), ASA I and II, scheduled for elective surgeries of <60 minutes duration requiring GA between March 2015 and June 2016. We used entropy to monitor adequate depth of anaesthesia and to ensure equipotency of anaesthetic administration in both groups. The state and response entropy was maintained between 40 and 60 by titrating the anaesthetic agents and opioid analgesics. The time of awakening, perioperative haemodynamics, postoperative recovery profile, adverse events and comparative cost of anaesthetic agents were analysed. The mean heart rate in the desflurane group was significantly higher. There was no difference between the blood pressure, end tidal carbon dioxide, or oxygen saturation in the two groups. There was a trend towards faster awakening, spontaneous respiration and extubation, quicker time to achieve a fast track score >12 and shift out of the post-anaesthesia care unit in the desflurane group, but the difference was not statistically significant. There were no serious adverse events. The mean cost of desflurane was significantly higher than propofol. Desflurane and propofol provided similar recovery profiles in children receiving GA for ambulatory surgeries. However, propofol was more cost effective compared to desflurane.