A comparison: the efficacy of sevoflurane-nitrous oxide or propofol-nitrous oxide for the induction and maintenance of general anesthesia.
OBJECTIVE
To compare sevoflurane-nitrous oxide with propofol-nitrous oxide for the induction and maintenance of anesthesia, and to determine the rates of recovery following each anesthetic.


METHODS
Randomized, controlled study.


METHODS
Teaching hospital.


METHODS
50 ASA physical status I and II patients, ranging in age from 18 to 70 years.


METHODS
General anesthesia was induced with either sevoflurane or propofol and maintained with 60% to 70% nitrous oxide and either sevoflurane or a propofol infusion and supplemental fentanyl. At the conclusion of surgery, the oxygen flow was increased to 6 L/min and all anesthetics were discontinued simultaneously. Patients were monitored for the nature and speed of induction and emergency from anesthesia.


RESULTS
Induction of anesthesia was significantly slower in the sevoflurane group than in the propofol group (2.0 +/- 1.1 vs. 0.8 +/- 0.5 min, respectively). The ease of induction and the time required for emergence from anesthesia were the same in both study groups (eye opening: 9.0 +/- 4.4 min vs. 8.0 +/- 5.0 min; following commands: 11.2 +/- 5.0 min vs. 9.8 +/- 6.9 min; extubation: 9.1 +/- 4.5 min vs. 8.6 vs. 5.1 min in the sevoflurane and propofol groups, respectively). Patients in the sevoflurane group experienced nausea and vomiting more frequently than patients in the propofol group (13 and 5 patients vs. 3 and 0 patients in the sevoflurane and propofol groups, respectively), which were not related to the administration of neostigmine or intraoperative opioids.


CONCLUSIONS
Sevoflurane allows for rapid inhalation induction of, and emergence from, general anesthesia.
Lien
C A
CA
Department of Anesthesiology, New York Hospital-Cornell Medical Center, New York 10021, USA.
Hemmings
H C
HC
Belmont
M R
MR
Abalos
A
A
Hollmann
C
C
Kelly
R E
RE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D004987:Ethers / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009325:Nausea / Q000139:chemically induced; D009609:Nitrous Oxide / Q000008:administration & dosage* / Q000009:adverse effects; D010100:Oxygen / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage*; D000077149:Sevoflurane; D013997:Time Factors; D014839:Vomiting / Q000139:chemically induced; D014851:Wakefulness
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D004987:Ethers; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide; D010100:Oxygen; D005283:Fentanyl; D015742:Propofol