Clinical study of desflurane on low flow anesthesia compared with sevoflurane and enflurane.
OBJECTIVE
To compare the hemodynamic change, course of recovery and adverse reaction in desflurane, sevoflurane and enflurane inhalation under low flow for patients undergoing selective abdominal surgery.


METHODS
Following thiopental induction, 42 patients were divided into three groups: the first group received desflurane, the second sevoflurane and the third enflurane. During surgery, one of the agents around 1 minimum alveolar concentration (MAC) was used for maintenance, with fresh gas flow of 0.3-0.5 L/min for either desflurane or enflurane, and (0.8-1.0) L/min for sevoflurane. Heart rate (HR), blood pressure and end-tidal anesthetic concentration were monitored continuously. Time intervals from cutting off anesthetic to patient opening eyes, following commands, stating the time and location and recalling date of birth were all recorded. In addition, postoperative nausea or vomiting was traced.


RESULTS
Desflurane caused the least cardiovascular depression. with mean arterial pressure (MAP) maintained significantly better at 10, 30 and 60 minutes of surgery and with HR stabilized right after incision as well. Its emergence was 2 times faster than sevoflurane, and 5-6 times quicker than enflurane. However, nausea or vomiting was found the lowest in patients receiving sevoflurane, though no distinct difference was shown between desflurane and enflurane. Nevertheless, patients under desflurane suffered less.


CONCLUSIONS
Desflurane offers significant advantages for clinical anesthesia maintenance over sevoflurane and enflurane. It provides minimal cardiovascular depression, much quicker recovery, yet still causes some nausea during emergence.
Xie
G
G
Department of Anesthesiology, Zhongshan Hospital, Shanghai Medical University, China.
Jiang
H
H
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation / Q000379:methods; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D000077335:Desflurane; D004737:Enflurane / Q000009:adverse effects*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007530:Isoflurane / Q000009:adverse effects / Q000031:analogs & derivatives*; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects; D008875:Middle Aged; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D004737:Enflurane; D000077335:Desflurane; D007530:Isoflurane