[Immediate anesthesia recovery and psychomotor function of patient after prolonged anesthesia with desflurane, sevoflurane or isoflurane].
OBJECTIVE
To compare the anesthetic maintenance and early postoperative recovery and psychomotor function in patients who have been anesthestized with desflurane, sevoflurane or isoflurane during prolonged open urological surgery.


METHODS
Seventy-five patients were randomly assigned to receive desflurane, sevoflurane or isoflurane with N2O 60% for anesthetic maintenance. The concentration of each drug was adjusted to maintain arterial pressure and heart rate +/- 20% of baseline. After the operation the anesthetics were discontinued and times until eye opening, spontaneous breathing, extubation and orientation were recorded. In the post-anesthesia recovery ward we applied the Newman-Trieger and Aldrete tests and recorded instances of nausea and vomiting and need for analgesia during the first 24 hours after surgery.


RESULTS
The groups were similar with regard to demographic features, anesthetic maintenance, duration of anesthesia and relative doses of the anesthetics used. Recovery times in the operating room were significantly shorter (p < 0.05) after anesthesia with desflurane and sevoflurane than with isoflurane, with no significant differences between the desflurane and sevoflurane groups (duration of anesthesia 198 +/- 90, 171 +/- 67 and 191 +/- 79; eye opening 7.6 +/- 3.7, 7.8 +/- 3.0 and 11.9 +/- 4.5; time until extubation 7.8 +/- 3.0, 8.3 +/- 3.0 and 11.0 +/- 3.5 for desflurane, sevoflurane and isoflurane, respectively; all data in minutes). Recovery in the post-anesthetic recovery ward was similar for all three groups.


CONCLUSIONS
Anesthetic maintenance was comparable with all three drugs. Desflurane and sevoflurane demonstrated advantages over isoflurane during recovery from anesthesia in the operating theater. No significant differences were found in psychomotor recovery, nausea and/or vomiting or requirements for postoperative analgesia.
Pensado Castiñeiras
A
A
Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Complexo Hospitalario Juan Canalejo, A Coruña. a_pensado@yahoo.com
Rama Maceiras
P
P
Molins Gauna
N
N
Fiqueira Moure
A
A
Vásquez Fidalgo
A
A
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000009:adverse effects* / Q000494:pharmacology; D000077335:Desflurane; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000494:pharmacology; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects* / Q000494:pharmacology; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009483:Neuropsychological Tests; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D017060:Patient Satisfaction; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000187:drug effects*; D000077149:Sevoflurane; D016037:Single-Blind Method; D013997:Time Factors; D013520:Urologic Surgical Procedures; D014839:Vomiting / Q000139:chemically induced
D000700:Analgesics; D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane