Abstract

Background: General anesthesia is the most commonly used technique in day care setup. An ideal general anesthetic should provide smooth and rapid induction, optimal operating conditions, and rapid recovery with minimal side effects such as nausea, vomiting, bleeding, and postoperative pain. Inhaled anesthetics allow rapid emergence from anesthesia because of easy titrability with inherent neuromuscular blocking effects that make them more suitable for day care anesthesia.
Objective: To compare intraoperative hemodynamic profile of desflurane and sevoflurane as maintenance anesthetic in patients undergoing day care gynecological laparoscopic surgery.
Materials and Methods: This was a prospective randomized single-blind study that was conducted by the Department of Anesthesiology at Krishna Institute of Medical Science, Secunderabad, India, during the period of January 2010 to May 2011 in patients undergoing day care gynecological laparoscopic surgery. The study was approved by the hospital ethics committee. A total of 100 female patients belonging to the American Society of Anesthesiologists grade I or II, scheduled to undergo day care laparoscopic gynecological surgery were recruited for the study. Patients were randomized into two groups to receive either desflurane (group D; n = 50) or sevoflurane (group S; n = 50) for maintenance of anesthesia. Result: All demographic parameters, such as age, weight, and height, were compared in both the groups and all parameters are statistically insignificant. The mean duration of surgery in the groups of desflurane and sevoflurane was 38.90 and 41.30 min, respectively. The groups did not differ in blood pressure (systolic, diastolic, and mean) or heart rate throughout the surgery. During the maintenance period, heart rate and mean arterial pressure were satisfactorily maintained within 20% of baseline values with both anesthetics. The time from administration of reversal agent to response to painful stimuli, to eye opening, to verbal commands, and spontaneous eye opening were significantly shorter in patients given desflurane than in patients given sevoflurane ( p = 0.000). For a given duration of anesthesia, emergence from anesthesia was significantly faster in desflurane group as compared to sevoflurane group. There was no difference in both the groups as far as the incidence of complications is concerned. Conclusion: Desflurane anesthesia produces faster emergence and early recovery from anesthesia compared to sevoflurane anesthesia. Time to home readiness is similar with both agents. Intraoperative hemodynamic parameters are similar in both desflurane and sevoflurane anesthesia.