Comparison of desflurane and propofol in the speed and the quality of emergence from anesthesia in patients undergoing lung cancer surgery—a prospective, randomized study

Abstract

Background Anesthesia with desflurane or propofol enables rapid emergence. In patients undergoing lung cancer surgery, however, the speed of emergence from desflurane, but not from propofol, may be affected by the deteriorated postoperative respiratory function. We prospectively compared the speed and quality of emergence between desflurane and propofol. Methods We conducted a parallel study. Eighty patients scheduled for lung cancer surgery were randomly allocated to Desflurane group (Group D) and Propofol group (Group P). Combined general and epidural anesthesia was performed in the identical way except for the anesthetic. Results There was no significant difference between the groups in the time to awakening, extubation, or orientation. However, emergence agitation (EA) occurred more frequently in Group D than in Group P (20/40 vs. 4/40, P<0.001). Numbers of patients not achieving full scores in respiration and circulation components of the modified Aldrete score 5 min after extubation were more in Group D (4/40 vs. 0/40, P=0.040; and 8/40 vs. 2/40, P=0.043, respectively). More patients required antiemetics during postoperative 24 hours in Group D (15/40 vs. 7/40, P=0.045). Conclusions Desflurane was not inferior to propofol in the speed of emergence from anesthesia after lung cancer surgery, but it was slightly inferior to propofol in the quality of emergence. Trial Registration UMIN-CTR identifier: UMIN000009221.

The feasibility of dexmedetomidine-led anesthesia maintenance strategy during major abdominal surgery

“…Previous study indicated that as an anesthesia adjunct, dexmedetomidine prolonged anesthesia emergence [ 41 ], but this study indicated that the emergence time of dexmedetomidine-led anesthesia was 4.8 min, which was shorter than short-duration anesthetic propofol (emergence time, 5.9 min) and desflurane (emergence time, 5.7 min) [ 42 ]. We provided intensive anesthesia depth monitoring during maintenance and no intraoperative awareness events occurred, but based on Wilson confidence interval calculation, the upper confidence limit of occurrence rate of intraoperative awareness was 3.27% (sample size = 30).…”