Comparison of recovery after intermediate duration of anaesthesia with sevoflurane and isoflurane

Abstract

After intermediate duration of anaesthesia administered to children for up to 90 min, isoflurane and sevoflurane allow recovery after approximatively the same lapse of time.

Pharmacoeconomics of Volatile Inhalational Anaesthetic Agents: An 11-Year Retrospective Analysis

“…As predicted from its lower solubility, immediate awakening after sevoflurane is more rapid than after isoflurane in some [17][18][19][20][21] but not all [22][23][24][25] studies. Further, in those studies where wake-up times differed, the average difference was only a few minutes 14 .…”

Isoflurane is associated with a similar incidence of emergence agitation/delirium as sevoflurane in young children – a randomized controlled study

“…The fact that we saw no difference in the incidences of EA and ED on both levels of EA therefore suggests a similarity of both anesthetics regarding this problem. Furthermore, in the second study EA was measured during a period of 24 h after anesthesia (8), where it may have been difficult to establish a consistent personal presence of the same blinded observer for all children as we did in our study. In addition, differences in pain control may also be important: the first study allowed different regional anesthesia techniques (7), in the second study all children received clonidine together with the caudal anesthesia (8).…”

“…In both studies, 20 children per group underwent procedures longer than 90 min with a regional anesthesia technique for postoperative analgesia. In the first study, the authors reported incidences of 40% for isoflurane and 25% for sevoflurane, but the difference did not reach statistical significance (7), in the second study a significantly higher incidence of agitation for sevoflurane compared with isoflurane was observed (8). In our opinion, there are some methodological issues which make it difficult to compare these results with our observations.…”

“…Despite its widespread use, only three investigations have studied the occurrence of EA in children after isoflurane. After long procedures, isoflurane produced higher (7) or lower (8) rates of EA compared with sevoflurane, and a recent observational study found no difference between the two volatile anesthetics (9).…”

Sevoflurane usage

“…There is evidence to suggest that sevoflurane has no better a recovery profile than isoflurane in terms of time to discharge from recovery [1–4] and causes more respiratory and cardiovascular problems [1] and postoperative nausea [1, 2]. The agitation seen in some patients (particularly preschool children) associated with sevoflurane recovery is well documented [5, 6].…”