Recovery characteristics of sevoflurane- or propofol-based anaesthesia for day-care surgery.
BACKGROUND
Sevoflurane has a low blood-gas partition coefficient resulting in a rapid recovery. Few studies have examined the maintenance and recovery characteristics of sevoflurane compared with propofol in a standardized outpatient population.


METHODS
The study was a multicentre study performed in 10 centres. One hundred and sixty-nine elective outpatients due for knee-arthroscopy received 100 mg diclofenac rectally as pain prophylaxis prior to induction of general anaesthesia with fentanyl 1.0-1.5 micrograms/kg + propofol 2.0-2.5 mg/kg i.v. Anaesthesia was maintained with 60% nitrous oxide in oxygen through a laryngeal mask and continuous administration of either: sevoflurane (group S) or propofol infusion (group P) in order to maintain stable haemodynamics. Data of postoperative function and side-effects were collected in a double-blind design, including a patient interview after 24 h.


RESULTS
The sevoflurane patients had a significantly faster emergence from anaesthesia, with response to commands at 6.9 +/- 0.4 min versus 8.2 +/- 0.4 min in the propofol group (P < 0.05, mean +/- SD). At 15 min after surgery, group S had a better score in the digit symbol substitution test and felt less confused in a visual analogue scale test compared with group P (P < 0.05). Peroperative bradycardia, nausea and vomiting and late postoperative dizziness were more common in group S. In the sevoflurane group, 32% had nausea or vomiting in the 24 h observation period compared with 18% for propofol (P < 0.05). There was no difference between group S and group P in postoperative pain, eligibility for recovery room discharge (75 +/- 12 versus 70 +/- 11 min) or home-readiness (155 +/- 12 versus 143 +/- 11 min).


CONCLUSIONS
Maintenance of anaesthesia with sevoflurane results in a more rapid emergence, but a higher incidence of nausea and vomiting compared with propofol. The side-effects were minor in our study, and did not result in any difference in time to discharge from the recovery ward or the hospital.
Raeder
J
J
Department of Anaesthesia, Ullevål Hospital, Oslo, Norway.
Gupta
A
A
Pedersen
F M
FM
D000328:Adult; D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D001182:Arthroscopy; D004311:Double-Blind Method; D004987:Ethers / Q000009:adverse effects; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008738:Methyl Ethers; D009325:Nausea / Q000139:chemically induced; D010149:Postoperative Pain; D015742:Propofol / Q000009:adverse effects; D000077149:Sevoflurane; D014839:Vomiting / Q000139:chemically induced
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D004987:Ethers; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol