Psychomotor performance after desflurane anesthesia: a comparison with isoflurane.
Recovery and psychomotor performance were studied in 80 ASA physical status I-III adult patients undergoing outpatient surgery. Patients were divided into four equal groups: thiopental induction of anesthesia followed by desflurane in nitrous oxide and oxygen (Th-DES-N2O/O2), thiopental induction of anesthesia followed by isoflurane in nitrous oxide and oxygen (Th-ISO-N2O/O2), thiopental induction of anesthesia followed by desflurane in oxygen (Th-DES-O2), and desflurane inhaled induction followed by desflurane in oxygen (DES-DES-O2). Patients were excluded from analysis if they required opioids or antiemetics postoperatively. The use of desflurane was associated with more rapid awakening compared with isoflurane (time to eye opening 9.45 +/- 0.67 min [Th-DES-N2O/O2] and 13.8 +/- 1.59 min [Th-ISO-N2O/O2], P less than 0.05). Psychomotor performance was measured using the choice reaction time and critical flicker fusion threshold. At 30 min after discontinuing anesthesia, five patients in the Th-ISO-N2O/O2 group and one patient in the Th-DES-N2O/O2 group were too sleepy to perform psychomotor tests. In addition, five patients who received Th-DES-O2 and one patient who received the inhaled induction and maintenance of anesthesia with desflurane in oxygen were too sleepy to perform tests at 30 min. Patients receiving Th-DES-N2O/O2 showed less impairment of choice reaction time than those receiving Th-ISO-N2O/O2. Critical flicker fusion threshold, however, showed no difference between groups. The use of thiopental was associated with delayed recovery. Compared with isoflurane, desflurane anesthesia is associated with more rapid initial awakening and less impairment of choice reaction time.
Fletcher
J E
JE
Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia 30308.
Sebel
P S
PS
Murphy
M R
MR
Smith
C A
CA
Mick
S A
SA
Flister
M P
MP
D000328:Adult; D000556:Ambulatory Surgical Procedures; D000769:Anesthesia, Inhalation; D000777:Anesthetics / Q000494:pharmacology*; D002755:Choice Behavior / Q000187:drug effects; D000077335:Desflurane; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000494:pharmacology*; D008297:Male; D009609:Nitrous Oxide / Q000494:pharmacology; D011597:Psychomotor Performance / Q000187:drug effects*; D011930:Reaction Time / Q000187:drug effects; D013874:Thiopental / Q000494:pharmacology; D013997:Time Factors
D000777:Anesthetics; D000077335:Desflurane; D007530:Isoflurane; D013874:Thiopental; D009609:Nitrous Oxide