Desflurane accelerates patient response during the wake-up test for scoliosis surgery.
OBJECTIVE
To evaluate if desflurane possesses a shorter wake-up onset time and less incidence of recall than fentanyl-based anesthesia.


METHODS
Forty ASA class I-II adolescents, were enrolled into either a desflurane (DES) group, or a fentanyl (FEN) group for scoliosis surgery. Bispectral index (BIS) was monitored continuously in all patients throughout the procedure; the relationship between the wake-up time and BIS value was evaluated.


RESULTS
Patients in the DES group had a significantly shorter wake-up onset than patients in the FEN group (4.1 +/- 0.6 vs 8.9 +/- 2.1 min, P < 0.01). No recall occurred during the wake-up test in the DES group, while five patients had recall in the FEN group, including two patients who recalled a given colour. Extubation time was significantly shorter in the DES group than in the FEN group (7.2 +/- 0.6 vs 16 +/- 11.9 min, P < 0.01). BIS values were significantly higher in the FEN group than in the DES group during anesthesia. (62 +/- 4.5 vs 42 +/- 5.3, P < 0.05) BIS after the wake-up test was similar in both groups (90 +/- 2.9 vs 93.8 +/- 2.5). There was a latency period (3.3 +/- 1.2 min) between the maximal BIS value and wake-up time in the FEN group but not in the DES group.


CONCLUSIONS
DES provides a significantly shorter onset time during the wake-up test and a rapid emergence after scoliosis surgery. BIS monitoring during the wake-up test was more informative when anesthesia was maintained with DES compared to FEN infusion.
Ting
Chien-Kun
CK
Department of Anesthesiology, Veterans General Hospital-Taipei, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Hu
Jenkin S
JS
Teng
Yun-Hui
YH
Chang
Ya-Ying
YY
Tsou
Mei-Yung
MY
Tsai
Shen-Kou
SK
D000293:Adolescent; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects; D000077335:Desflurane; D004569:Electroencephalography; D005283:Fentanyl / Q000494:pharmacology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000494:pharmacology*; D011939:Mental Recall / Q000187:drug effects; D016343:Monitoring, Intraoperative / Q000379:methods; D009949:Orientation / Q000187:drug effects; D011930:Reaction Time / Q000187:drug effects*; D012600:Scoliosis / Q000601:surgery*; D013997:Time Factors; D014851:Wakefulness / Q000502:physiology*
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000077335:Desflurane; D007530:Isoflurane; D005283:Fentanyl