A comparative study between desflurane and sevoflurane in recovery time and recovery characteristics on patients for elective orthopedic procedure
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Date
2006-05
Authors
Alias, Raja Liza Raja
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia
Abstract
The safety of anaesthetic recovery is closely related to the speed of which the patient
reaches a state of stable circulation, respiration and well maintained reflexes. Apart from
the risk of surgical complications, the risk of residual anaesthetic effects, are the reason for
keeping patients in a highly staffed, and high surveillance recovery unit.
With the new rapidly eliminated inhalational anaesthetic agent, such as destlurane, having
low blood gas solubility coefficient (0.42), it is supposed to offer a rapid recovery. The socalled
fast-track concept means that the patient is so well recovered when he leaves the
operating theatre that tbe recovery unit may be by-passed without any risk for the patient.
A randomized single blinded prospective study was conducted in Hospital Universiti Sains
Malaysia from June 2004 to Jooe 2005 involving a total of 60 ASA I patients planned fur
elective orthopedic procedures with duration of surgery less then 2 hours. The patients
were allocated into 2 equally numbered groups, desflurane (n=30) and sevoflurane (n=30).
The objectives of the study were to compare the effect of desflurane versus sevoflurane as
inhalational agent for maintenance, on recovery time and side effects.
All patients were induced with intravenous fentanyl, propofol and atracurium.
Intraoperatively, either desflurane 6% or sevoflurane 2% (which are equivalent to lMAC
of both agents in 1000.4 oxygen) was used together with 30010 oxygen and 700,4, nitrous
oxide. Atracmimn infusion was used as a muscle relaxant and fentanyl was given for
analgesia. Hemodynamic parameters (blood pressure and heart rate) were recorded on
arrival, pre ... intubation, post-intubation and every l 0 minutes until the end of the surgery.
Bispectral index scale (BIS) was used to monitor anaesthetic depth.
During emergence, stimulation of patients was limited to verbal encouragement to open
eyes with a tap on the shoulder at 10 seconds interval. Time was recorded from
discontinuation of anaesthetic until patients opened their eyes and obeyed simple
commands. The changes in BIS values with time were recorded as the inhalational agent
was discontinued. At the same time, patients were observed for any complications during
emergence and at the recovery room.
From this study, there was significant difference between desfturane and sevotlurane in
tenns of recovery time, which included time to open eyes (7 .2l:r 1.82 minutes, for
destlurane versus 12.55±2.70 minutes, for sevoflurane with p < 0.001) and time to obey
command (8.33±1.77 minutes, for desflurane versus 13.52±2.65 for sevotlurane with p <
0.001 ), with the duration of operation within 2 hours. The changes in BIS values with time
showed significance difference between the groups, which was ~ with desfluranegroups. However, there was no significant difference in term of hemodynamic parameters
between the groups. There were 5 (16. 7%) incidence of complications during
emergence/recovery in patients who received sevoflurane. However it was not statistically
significant.
In summary, this study showed that desflurane has a faster recovery time with similar
hemodynamic and side effects as compared to sevoflurane.
Description
Keywords
Anesthesia