The recovery time of sevoflurane and desflurane and the effects of anesthesia on mental and psychomotor functions and pain

Ergönenç, Jalan; Ergönenç, Tolga; İdin, Kadir; Uzun, Uğur; Dirik, Ali; Gedikli, Gökhan; Bican, Gülşen

doi:10.4103/0259-1162.143151

Cited by 20 publications

(32 citation statements)

References 12 publications

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“…However, there was no difference in the incidence of pain between the two volatiles, which is in accordance with previous studies assessing pain prior to discharge. [6, 7, 23] Similarly, we found no differences in cognitive Recovery between sevoflurane and desflurane, which is also consistent with studies showing no differences in the immediate postoperative period. [7, 8, 23–25] Nevertheless, the current study went further to describe potential differences in intermediate and long-term recovery.…”

Section: Discussionsupporting

confidence: 91%

A randomized trial of desflurane or sevoflurane on postoperative quality of recovery after knee arthroscopy

et al. 2019

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Background Studies have described different recovery profiles of sevoflurane and desflurane typically early after surgery. Methods We conducted a randomized superiority trial to determine whether Overall Recovery 3 days after knee arthroscopy would be superior with desflurane. Adult participants undergoing knee arthroscopic surgery with general anesthesia were randomized to either desflurane or sevoflurane general anesthesia. Intraoperative and postoperative drugs and analgesics were administered at the discretion of the anesthesiologist. Postoperative quality of recovery was assessed using the “Postoperative Quality of Recovery Scale”. The primary outcome was Overall Recovery 3 days after surgery and secondary outcomes were individual recovery domains at 15 minutes, 40 minutes, 1 day, 3 days, 1 month, and 3 months. Patients and researchers were blinded. Results 300 patients were randomized to sevoflurane or desflurane (age 51.7±14.1 vs. 47.3±13.5 years; duration of anesthesia 24.9±11.1 vs. 23.3±8.3 minutes). The proportion achieving baseline or better scores in all domains increased over the follow-up period in both groups but was not different at day 3 (sevoflurane 43% vs. desflurane 37%, p = 0.314). Similarly, rates of recovery increased over time in the five subdomains, with no differences between groups for physiological, p = 0.222; nociceptive, p = 0.391; emotive, p = 0.30; Activities-of-daily-living, p = 0.593; and cognitive recovery, p = 0.877. Conclusion No significant difference in the quality of recovery scale could be shown using sevoflurane or desflurane general anesthesia after knee arthroscopy in adult participants.

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Section: Discussionsupporting

confidence: 91%

A randomized trial of desflurane or sevoflurane on postoperative quality of recovery after knee arthroscopy

et al. 2019

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“…Although early studies have reported high incidences of postoperative hypoxemia (as high as 55%) [ 28 ], incidences have decreased to around 20% by the mid-2010s [ 25 – 27 , 29 ]. Such a decrease might have been related to the increased availability of new and short-acting anesthetic drugs [ 30 , 31 ], comprehensive pharmacological knowledge, and multimodal analgesia techniques for maximizing postoperative pain relief while minimizing side effects, and new minimally invasive surgery options. Thus, routine supplemental oxygen administration to prevent hypoxemia might not be necessary in most postoperative patients in recent years.…”

Section: Prevention Of Postoperative Hypoxemiamentioning

confidence: 99%

Oxygen administration for postoperative surgical patients: a narrative review

Suzuki

2020

j intensive care

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Most postoperative surgical patients routinely receive supplemental oxygen therapy to prevent the potential development of hypoxemia due to incomplete lung re-expansion, reduced chest wall, and diaphragmatic activity caused by surgical site pain, consequences of hemodynamic impairment, and residual effects of anesthetic drugs (most notably residual neuromuscular blockade), which may result in atelectasis, ventilation–perfusion mismatch, alveolar hypoventilation, and impaired upper airway patency. Additionally, the World Health Organization guidelines for reducing surgical site infection have recommended the perioperative administration of high-dose oxygen, including during the immediate postoperative period. However, supplemental oxygen and hyperoxemia also have harmful effects on the respiratory and cardiovascular systems, with several clinical studies having reported an association between high perioperative oxygen administration and worse clinical outcomes. Recently, the increased availability of new and short-acting anesthetic drugs, comprehensive pharmacological knowledge, postoperative multimodal analgesia, and new minimally invasive surgery options could result in lower incidences of postoperative hypoxemia. Moreover, recommendations promoting high oxygen administration to prevent surgical site infections have been challenged, considering the lack of scientific investigations, and have not been widely accepted. Given the potential harmful effects of hyperoxemia, routine postoperative oxygen administration might not be recommended. Recent clinical studies have indicated that a conservative approach to oxygen therapy, where oxygen administration is titrated to achieve slightly lower oxygen levels than usual, could be safely implemented and decrease acutely ill patients’ susceptibility to hyperoxemia. Based on current evidence, appropriate monitoring, including peripheral oxygen saturation, and oxygen titration should be required during postoperative oxygen administration to avoid both hypoxemia and hyperoxemia. Future trials should therefore focus on determining the optimal oxygen target during postoperative care.

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“…Currently, sevoflurane is widely used in clinical because of its rapid onset of action, quick and complete recovery, good controllability and fewer side effects [19]. But due to its unclear pharmacological mechanism, the effects of sevoflurane on vital organs such as lung, kidney, liver and brain are also inconsistent even through there are many related reports In this study, we found that 2% sevoflurane inhibited HUVECs migration function time-dependently.…”

Section: Discussionmentioning

confidence: 59%

Sevoflurane inhibits Human umbilical vein endothelial cells migration by up-regulating VE-cadherin expression

Sun¹,

Zhao²,

Xu³

et al. 2020

Preprint

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Background Sevoflurane is a commonly used inhalation anesthesia and is famous for rapid onset of action, less metabolism in vivo and fast recovery. The aim of this study is to elaborate whether sevoflurane inhibits Human umbilical vein endothelial cells (HUVECs) migration function.Methods In vitro experiments, the HUVECs were divided into four groups randomly, and were exposed to 2% sevoflurane, refer to 1.6 minimal alveolar concentration (MAC), respectively for 0.5h, 1h, 2h and the first group was the control group which exposed to the same gas environment with other three groups but only without sevoflurane. After sevoflurane exposure, HUVECs were conducted the scratch assay.Results The results suggested that the HUVECs exposed to 2% sevoflurane for 2 h were more obviously inhibited on the migration distance during 12 h after scratched than the control group. Quantitative PCR results suggested that the HUVECs exposed to 2% sevoflurane for 2 h expressed more vascular endothelial cadherin (VE-cadherin) than the control group, with statistic difference. However, other scratch assay and quantitative trials suggested that the HUVECs which were transfected with VE-cadherin siRNA and exposed to 2% sevoflurane for 2 h had no significant difference with the control group on the migration distance and the expression of VE-cadherin.Conclusion These results suggested that sevoflurane inhibited the HUVECs migration function by up-regulating VE-cadherin expression, and may have an adverse effect on the normal functions of vascular endothelial cells.

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The recovery time of sevoflurane and desflurane and the effects of anesthesia on mental and psychomotor functions and pain

Cited by 20 publications

References 12 publications

A randomized trial of desflurane or sevoflurane on postoperative quality of recovery after knee arthroscopy

A randomized trial of desflurane or sevoflurane on postoperative quality of recovery after knee arthroscopy

Oxygen administration for postoperative surgical patients: a narrative review

Sevoflurane inhibits Human umbilical vein endothelial cells migration by up-regulating VE-cadherin expression

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