Title: Clinical evaluation of Desflurane versus Sevoflurane in laparoscopic surgery
Authors: Dr Vrishali Ankalwar, Dr Anuja Dharmale, Dr Vijay Patil , Dr Naresh Tirpude
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.72
Abstract
Aims and Objectives: The present study was undertaken to evaluate desflurane in terms of hemodynamic stability, recovery profile and perioperative complications and compare results of desflurane with routinely used sevoflurane for laparoscopic surgery.
Methods: Eighty patients of either sex, scheduled for laparoscopic surgeries under general anaesthesia were randomly allocated into two groups i.e. Group D and Group S. Patients of Group D received desflurane and of Group S received sevoflurane as an inhalational anesthetic. The intraoperative haemodynamic parameters, recovery characteristics and postoperative complications were observed and compared between two groups.
Results: Intraoperative MAP and HR did not differ between the two groups (P > 0.05). Desflurane led to faster early recovery but the intermediate recovery was similar in both the groups. The incidence of postoperative complications was comparable in both the groups but incidence of coughing was more in desflurane group which was self limiting.
Conclusion: Desflurane can be used as an effective alternative to sevoflurane for maintenance of anaesthesia in laparoscopic procedures.
Keywords: Desflurane, Sevoflurane, Laparoscopic surgery, Early recovery, Modified Aldrete Score.
References
1. Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ et al Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6(7):477-484.
2. Gergin S, Cevik B, Yildirim G, Ciplakligil E, Colakoglu S. Sevoflurane Vs Desflurane: Haemodynamic Parameters and Recovery Characteristics. The Internet Journal of Anesthesiology. 2004;9(1).
3. Nathanson MH, Fredman B, Smith I, White PF. Sevoflurane versus desflurane for outpatient anaesthesia: A comparison of maintenance and recovery profiles. Anesth Analg. 1995;81:1186–1190.
4. Eberts TJ, Schmid PG. Inhaled anesthetics. In: Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, editors. Clinical Anesthesia. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2009;413–443.
5. White PF. Studies of desflurane in outpatient anaesthesia. Anesth Analg. 1992;75(4):47-53.
6. Ebert TJ, Muzi M. Sympathetic hyperactivity during desflurane anesthesia in healthy volunteers. A comparison with isoflurane. Anesthesiology 1993;79:444-453.
7. Weiskopf RB, Moore MA, Eger El II, et al. Rapid increase in desflurane concentration is associated with greater transient cardiovascular stimulation than with rapid increase in isoflurane concentration in humans. Anesthesiology 1994;80:1035-1045.
8. Van Hemelricjk J, Smith I, and White PF. Use of desflurane for outpatient anesthesia. A comparison with propofol and nitrous oxide. Anesthesiology 1991;75:197-203.
9. Kaur A, Jain AK, Sehgal R, Sood J. Hemodynamics and early recovery chara-cteristics of desflurane versus sevoflurane in bariatric surgery. J Anaesthesiol Clin Pharmacol. 2013;29(1):36-40.
10. Dupont J, Tavernier B, Ghosez Y, Durinck L, Thevenot A, Moktadir- ChalonsN, Ruyffelaere-Moises L, Declerck N, Scherpereel P. Recovery after anaesthesia for pulmonary surgery: desflurane, sevoflurane and isoflurane.Br J Anaesth.1999;82(3):355-359.
11. McKay RE, Large MJ, Balea MC, McKay WR.Airway reflexes return more rapidly after desflurane anesthesia than after sevoflurane anesthesia. Anesth Analg. 2005;100(3):697-700.
12. Avidan MS, Zhang L, Burnside BA, et al. Anesthesia awareness and the bispectral index. N Engl J Med 2008;358:1097-1108.
13. Aranake A, Mashour GA, Avidan MS. Minimum alveolar concentration: ongoing relevance and clinical utility. Anaesthesia 2013;68:512–522.
14. Jindal R, Kumra VP, Narani KK, Sood J.Comparison of maintenance and emergence characteristics after desflurane or sevoflurane in outpatient anaesthesia. Indian J Anaesth. 2011;55(1):36-42.
15. Vallejo MC, Sah N, Phelps AL, O'Donnell J, Romeo RC. Desflurane versus sevoflurane for laparoscopic gastroplasty in morbidly obese patients. J Clin Anesth. 2007;19(1):3-8.
16. Gökçek E, Kaydu A, Akdemir MS, Akil F, Akıncı IO. Early postoperative recovery after intracranial surgical procedures. Comparison of the effects of sevoflurane and desflurane. Acta Cir Bras. 2016;31(9):638-644.
17. Mahmoud NA, Rose DJ, Laurence AS. Desflurane or sevoflurane for gynaecological day-case anaesthesia with spontaneous respiration? Anaesthesia. 2001;56(2):171-174.
18. White PF, Tang J, Wender RH, Yumul R, Stokes OJ, Sloninsky A, Naruse R, Kariger R, Norel E, Mandel S, Webb T, Zaentz A. Desflurane versus sevoflurane for maintenance of outpatient anesthesia: the effect on early versus late recovery and perioperative coughing. Anesth Analg. 2009;109(2):387-393.