Desflurane versus propofol maintenance for outpatient laparoscopic cholecystectomy.
BACKGROUND
The aims of the study were to evaluate costs and clinical characteristics of desflurane-based anaesthetic maintenance versus propofol for outpatient cholecystectomy.


METHODS
All 60 patients received ketamine 0.2 mg kg(-1), fentanyl 2 microg kg(-1) and propofol 2 mg kg(-1) for induction. Ketorolac 0.4 mg kg(-1) and ondansetron 0.05 mg kg(-1) +droperidol 20 microg kg(-1) was given as prophylaxis for postoperative pain and emesis, respectively. The patients were randomly assigned into Group P with propofol maintenance and opioid supplements, or Group D with desflurane in a low-flow circuit system.


RESULTS
All the patients were successfully discharged within 8 h without any serious complications. Emergence from anaesthesia was more rapid after desflurane; they opened their eyes and stated date of birth at mean 6.4 and 8.4 min respectively, compared with 9.6 and 12 min in the propofol group (P<0.05). Nausea and pain were more frequent in Group D, 40% and 80% respectively; versus 17% and 50% in Group P (P<0.05). By telephone interview at 24 h and 7 d after the procedure, there was no major difference between the groups. With desflurane, drug costs per case were 10 $ lower than with propofol.


CONCLUSIONS
We conclude that desflurane is cheaper and has a more rapid emergence than propofol for outpatient cholecystectomy. However, propofol results in less pain and nausea in the recovery unit. Despite ondansetron and droperidol prophylaxis, there was still a substantial amount of nausea and vomiting after desflurane.
Raeder
J C
JC
Department of Anaesthesia, Ullevaal University Hospital, Oslo, Norway.
Mjåland
O
O
Aasbø
V
V
Grøgaard
B
B
Buanes
T
T
D000556:Ambulatory Surgical Procedures / Q000191:economics; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000762:Anesthesia Recovery Period; D000778:Anesthetics, Dissociative / Q000008:administration & dosage; D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D000932:Antiemetics / Q000627:therapeutic use; D017081:Cholecystectomy, Laparoscopic / Q000191:economics; D003365:Costs and Cost Analysis; D000077335:Desflurane; D004329:Droperidol / Q000627:therapeutic use; D016527:Drug Costs; D005069:Evaluation Studies as Topic; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics; D007649:Ketamine / Q000008:administration & dosage; D020910:Ketorolac; D008297:Male; D009325:Nausea / Q000139:chemically induced; D017294:Ondansetron / Q000627:therapeutic use; D010149:Postoperative Pain / Q000517:prevention & control; D010351:Patient Discharge; D011183:Postoperative Complications / Q000139:chemically induced / Q000517:prevention & control; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D014046:Tolmetin / Q000031:analogs & derivatives / Q000627:therapeutic use; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control
D018712:Analgesics, Non-Narcotic; D000778:Anesthetics, Dissociative; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000932:Antiemetics; D017294:Ondansetron; D007649:Ketamine; D000077335:Desflurane; D007530:Isoflurane; D014046:Tolmetin; D004329:Droperidol; D005283:Fentanyl; D015742:Propofol; D020910:Ketorolac