Recovery Profile after Inhalation Anesthesia Using Sevoflurane and Desflurane

Background: Sevoflurane and Desflurane are new inhalation anesthetics with a low blood/gas solubility which should allow a fast induction and emergence from anesthesia. This study was designed to compare the induction and recovery characteristics of gynecologic surgical patients receiving sevoflurane, desflurane or isoflurane with nitrous oxide for the maintenance of general anesthesia. Methods: After a standardized induction of anesthesia with fentanyl, propofol, succinylcholine and tracheal intubation, patients undergoing an elective gynecologic surgery lasting 1-2 hr randomly received sevoflurane (n = 23), desflurane (n = 21) or isoflurane group (n = 20). Induction, recovery time and the incidence of postoperative nausea and vomiting, and recall were compared among groups. The liver (SGOT, SGPT, ALP) and renal (BUN, serum creatinine) function were evaluated before and after the operation. Results: Although anesthetic conditions were similar during the operation in the three groups, significant differences were noted in induction and recovery profiles from anesthesia. Induction time was 201 67 sec for sevoflurane, 124 66 sec for desflurane and 422 257 sec for isoflurane. The time required for the end-tidal concentration of anesthetics to decrease by 50% was 180.9 34.4 sec for sevoflurane, 168.0 160.1 sec for desflurane, and 222.9 127.5 sec for isoflurane. The time to response (eye opening following a simple command), and orientation (recall of name and date of birth), to reach 10 points of the PAR (post anesthesia recovery) score and discharge from recovery room were significantly shorter after sevoflurane and desflurane than after isoflurane. There were no significant differences in liver and kidney functions between the periods before and after the operation among the groups. The frequency of side effects such as nausea, vomiting and recall during the postoperative period was similar among the groups. Conclusions: It is concluded that a balanced anesthetic technique using sevoflurane and desflurane as the main anesthetics has certain advantages compared with isoflurane in terms of faster emergence.