Haemodynamic stability during moderate hypotensive anaesthesia for spinal surgery. A comparison between desflurane and isoflurane.
BACKGROUND
The aim of this study was to compare desflurane and isoflurane for spinal procedures requiring moderate levels of controlled arterial hypotension, when these agents were administered via a semi-closed circuit at 1 l x min(-1) fresh gas flow.


METHODS
After ethics committee approval and written informed consent, 20 ASA I or II patients were randomly allocated to receive either desflurane (n=10) or isoflurane (n=10), in O2/ N2O (1:1) for maintenance of anaesthesia. Induction of anaesthesia, fentanyl dosing and volume loading were standardized. Blood pressure was invasively monitored and maintained within a target systolic blood pressure (SBP) range of 80 to 100 mmHg during the study period. Results were presented as medians and interquartiles, and non-parametric statistical methods were used.


RESULTS
Patient demographic data, SBP and heart rate prior to surgery, and duration of the procedure were similar between the two groups. During the study period, tighter arterial blood pressure control was maintained with desflurane as compared with isoflurane. SBP was 21.2% (9.5-41.7) of time outside the range 80-100 mmHg with isoflurane and 5.1% (0.6-10.3) with desflurane (P<0.01).


CONCLUSIONS
Desflurane, administered via a semi-closed circuit at 1 l x min(-1) fresh gas flow, maintained better haemodynamic stability in spinal surgery requiring moderate arterial hypotension than isoflurane.
Beaussier
M
M
Department of Anaesthesia and Intensive Care , St Antoine University Hospital, Paris, France. marc.beaussier@sat.ap-hop-paris.fr
Paugam
C
C
Deriaz
H
H
Mestari
M
M
Chandon
M
M
Sautet
A
A
Lienhart
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D000077335:Desflurane; D005260:Female; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007023:Hypotension, Controlled; D007530:Isoflurane / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D012129:Respiratory Function Tests; D013131:Spine / Q000601:surgery*
D000077335:Desflurane; D007530:Isoflurane