Recovery after anaesthesia for pulmonary surgery: desflurane, sevoflurane and isoflurane

Abstract

We have studied maintenance and recovery profiles after general anaesthesia with sevoflurane, desflurane and isoflurane in 100 patients undergoing pulmonary surgery. End-tidal concentrations of anaesthetic required to maintain mean arterial pressure and heart rate within 20% of baseline values were 1.4 +/- 0.6% for sevoflurane, 3.4 +/- 0.9% for desflurane and 0.7 +/- 0.3% for isoflurane. The three anaesthetics had comparable haemodynamic effects and arterial oxygenation during one-lung ventilation. Emergence was twice as fast with desflurane than with sevoflurane or isoflurane (mean times to extubation: 8.9 (SD 5.0) min, 18.0 (17.0) min and 16.2 (11.0) min for desflurane, sevoflurane and isoflurane, respectively). Early recovery (Aldrete score, cognitive and psychomotor functions) was also more rapid after desflurane. In pulmonary surgery, desflurane, but not sevoflurane, allowed more rapid emergence and earlier recovery than isoflurane.

Propofol/remifentanil vs sevoflurane/remifentanil for long lasting surgical procedures: a randomised controlled trial

“…For total intravenous anaesthesia with propofol and remifentanil, mean (SD) times to tracheal extubation of between 3.8 (1.9) min and 11.0 (3.7) min [4,5] have been reported. Extubation times after sevoflurane anaesthesia have also greatly differed, ranging from 10.0 (3.2) min to 18.0 (17.0) min [6,7]. One reason for this variability and a common problem of pharmacological studies is the non-comparable depth of anaesthesia between study groups.…”

Cognitive function recovery rate in early postoperative period: comparison of propofol, sevoflurane and isoflurane anesthesia

“…Isofl urane is present in anaesthesiological practice for a long time and there are various studies that explored eff ects of isofl urane on cognitive performance in postoperative period. Study conducted by Tsai et al in year 1992, explored infl uence of isofl urane and desfl urane on cognitive dysfunction in patients undergoing elective orthopaedic surgery and found desfl urane to be superior to isofl urane regarding cognitive recovery (14). Th ese results were also confi rmed in studies conducted by Dupont et al and Loscar et al in patients who underwent elective thoracic surgery (15,16).…”

Emergence and Recovery Characteristics After Low Flow Anaesthesia With Desflurane and Sevoflurane in Cancer Patients Administered Combined Epidural and General Anaesthesia

“…Average emergence time after desflurane has been reported to be half that of sevoflurane in patients undergoing pulmonary surgery. [6] We in our study used seven different parameters to assess immediate recovery and compared time intervals to achieve the same between the two groups. Recovery with sevoflurane was significantly delayed in all the seven parameters and was 1.3-1.6 times that with desflurane.…”

“…[10,11] Strum et al had supplemented general anaesthesia with epidural analgesia for open surgical procedures in morbidly obese patients. [6] But he administered age adjusted 1 MAC end-tidal concentrations of inhalational agents (desflurane/sevoflurane) and did not account for the MAC sparing effect of epidural local anaesthetics and opioids. None of the other studies comparing emergence with sevoflurane or desflurane have used epidural analgesia.…”