PURPOSE:
Desflurane has lower solubility and hence allows for more rapid emergence and recovery compared with sevoflurane. Nevertheless, after volatile induction with sevoflurane, shifting to another volatile agent for rapid emergence and recovery is a proposed theory. The present study is aimed to elucidate the effects of changing from sevoflurane to desflurane during the early part of anaesthesia.
AIM OF THE STUDY:
The aim of the study is to elucidate the effects on the recovery profile when changing from sevoflurane to desflurane during the early part of anaesthesia in patients undergoing elective laparoscopic surgeries under General Anaesthesia: A randomised controlled study.
METHODS:
Seventy patients who were scheduled for elective laparoscopic surgeries with general anaesthesia were enrolled in this randomized controlled study. Anaesthesia was induced with volatile induction consisting of 100% oxygen (6 L/min) and 5% sevoflurane. For anaesthesia maintenance, patients were randomized to receive either sevoflurane or desflurane in order to maintain a BIS vale of 40 - 60. In the desflurane group, the anaesthetic agent was changed from sevoflurane to desflurane within ten minutes of endotracheal intubation. After surgery, the following endpoints were assessed: the time from discontinuing volatile anaesthetics to eye opening, obeying the command to squeeze the investigator’s hand, tracheal extubation, orientation to the patients’ full name, usage of agents to attenuate the emergence phenomenon and time taken to shift the patient out of the operating room.
RESULTS:
In Group S maintained with sevoflurane, the shortest time for eye opening after cutting the anaesthetic agent is 14 mins and the longest time for the same is 21 mins. The mean time is 17.5 mins. In Group D maintained with desflurane, the shortest time for eye opening after cutting the anaesthetic agent is 5 mins and the longest time for the same is 8 mins. The mean time is 6.7 mins. The p value is < 0.01 which is quite significant. Likewise the shortest time taken to shift the patient out of the OT is 24 mins and the longest time is 32 mins in Group S with a mean value of 21.7 mins. In Group D, the shortest time taken to shift the patient out of the OT is 8 mins and the longest time is 11 mins with a mean value of 9.7 mins. The ‘p’ value on comparing the time taken to shift the patient out of the OT in both groups is < 0.01 which is significant.
Similarly, the time taken to hand squeezing, extubation and the patient’s ability to tell his full name is found to be significantly longer in the sevoflurane group when compared to the desflurane group. During emergence, however, supplemental drugs had to be administered in 11 patients of the sevoflurane group.
CONCLUSION:
Changing the anaesthetic agent from sevoflurane to desflurane after sevoflurane induction provides faster emergence and recovery compared with sevoflurane anaesthesia
