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Comparative effects of desflurane and isoflurane on recovery after long lasting anaesthesia

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Abstract

Purpose

Increasing the duration of exposure could lead to amplification of the pharmacokinetic differences between halogenated anaesthetic agents. The aim of our study was to compare anaesthesia recovery after desflurane and isoflurane, administered for more than three hours.

Methods

After informed consent, patients were randomly assigned to either desflurane (n = 15) or isoflurane (n = 15) groups. At the end of surgery, halogenated agents were discontinued and fresh gas flow was increased to 6 l · min−1 oxygen 100%.

Results

Mean anaesthesia duration was 292 ± 63 and 304 ± 91 min in the desflurane and isoflurane groups respectively. After desflurane and isoflurane discontinuation, the time to opening eyes was 12 ± 7 and 24 ± 11 min respectively (P < 0.001); to squeeze fingers at command was 17 ± 11 and 35 ± 19 min (P < 0.001); to extubation was 16 ± 6 and 33 ± 13 min (P < 0.001); to give their name was 22 ± 12 and 43 ± 21 min (P < 0.001); to achieve a Steward score of 6 was 28 ± 16 and 57 ± 33 min (P < 0.001), to be fit for discharge from the recovery room was 46 ± 19 and 81 ± 37 min (P < 0.003). Ranges of times to reappearance of recovery variables in the desflurane group were less than those after isoflurane (P < 0.05).

Conclusion

After long duration anaesthesia lasting up to three hours, desflurane allowed recovery and extubation in approximately half the time required by isoflurane. Less variability in results suggests better predictability of recovery with desflurane.

Résumé

Objectif

Les différences pharmacodynamiques entre les agents halogènes sont amplifiées par la durée d’administration. Ce travail compare les paramètres de réveil après une anesthésie supérieure à trois heures avec de l’iso-flurane ou du desflurane.

Méthode

Après consentement éclairé, les patients ont été répartis par tirage au sort pour recevoir de l’isoflurane (n = 15) ou du desflurane (n = 15). Au dernier point de suture cutanée, l’administration d’agent halogène était stoppée et le débit de gaz frais porté à 6 l · min−1 d’oxygène.

Résultats

La durée d’anesthésie a été de 292 ± 63 et 304 ± 91 min pour le desflurane et l’isoflurane respectivement. Le délai pour l’ouverture des yeux a été de 12 ± 7 et 24 ± 11 min (P < 0.001); pour serrer les mains à la demande de 17 ± 11 et 35 ± 19 min (P < 0.001); pour l’extubation de 16 ± 6 et 33 ± 13 min (P < 0.001); pour donner son nom de 22 ± 12 et 43 ± 21 min (P < 0.001); pour récupérer un score de Steward à 6 de 28 ± 16 et 57 ± 33 min (P < 0.001); pour avoir l’autorisation de sortie de salle de réveil de 46 ± 19 et 81 ±37 min (P < 0.003) pour le desflurane et l’isoflurane respectivement.

Conclusion

Après une anesthésie supérieure à trois heures, le desflurane permet un réveil et une extubation approximativement deux fois plus rapide que l’isoflurane. La plus faible variabilité des valeurs suggère une meilleure prédictibilité des paramètres de réveil avec le desflurane.

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Author information

Correspondence to Marc Beaussier.

Additional information

Supported by a grant from Pharmacia France, St Quentin-Yvelyne, France.

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Beaussier, M., Deriaz, H., Abdelahim, Z. et al. Comparative effects of desflurane and isoflurane on recovery after long lasting anaesthesia. Can J Anaesth 45, 429–434 (1998). https://doi.org/10.1007/BF03012578

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Keywords

  • Isoflurane
  • Nitrous Oxide
  • Recovery Room
  • Desflurane
  • Tympanic Temperature