title: A multicenter comparison of maintenance and recovery with sevoflurane or isoflurane for adult ambulatory anesthesia. The Sevoflurane Multicenter Ambulatory Group.
abstract: Sevoflurane was compared with isoflurane in 246 adult ASA class I-III patients undergoing ambulatory surgery. After administration of midazolam 1-2 mg and fentanyl 1 microgram/kg, anesthesia was induced with propofol 2 mg/kg and maintained with either sevoflurane or isoflurane in 60% nitrous oxide to maintain arterial blood pressure at +/- 20% of baseline. Fresh gas flows were 10 L/min during induction and 5 L/min during maintenance. Times to eye opening, command response, orientation, and ability to sit without nausea and/or dizziness were significantly faster after sevoflurane. Significantly more sevoflurane patients met Phase 1 of postanesthesia care unit (PACU) Aldrete recovery criteria (> or = 8) at arrival, 95% vs 81%. Also, significantly more sevoflurane patients were able to complete psychomotor recovery tests during the first 60 min postanesthesia. Discharge times were not different. Sevoflurane patients had significantly lower incidences of postoperative somnolence (15% vs 26%) and of nausea both in the PACU (36% vs 51%) and in the 24-h postdischarge period (9% vs 24%). Patient satisfaction was high overall (sevoflurane 97%, isoflurane 93%). We conclude that sevoflurane is a useful inhaled anesthetic for maintenance of ambulatory anesthesia.
authors.affiliation: Brigham & Women's Hospital, Boston, MA 02115, USA.
authors.forename: B K
authors.initials: BK
authors.lastname: Philip
authors.forename: S K
authors.initials: SK
authors.lastname: Kallar
authors.forename: M S
authors.initials: MS
authors.lastname: Bogetz
authors.forename: M S
authors.initials: MS
authors.lastname: Scheller
authors.forename: B V
authors.initials: BV
authors.lastname: Wetchler
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001794:Blood Pressure; D004987:Ethers / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage*; D008297:Male; D008738:Methyl Ethers; D009325:Nausea / Q000517:prevention & control; D009609:Nitrous Oxide / Q000008:administration & dosage; D017060:Patient Satisfaction; D011597:Psychomotor Performance / Q000187:drug effects; D000077149:Sevoflurane; D012894:Sleep Stages; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D004987:Ethers; D008738:Methyl Ethers; D000077149:Sevoflurane; D007530:Isoflurane; D009609:Nitrous Oxide