title: Meta-analysis of trials comparing postoperative recovery after anesthesia with sevoflurane or desflurane.
abstract: OBJECTIVE
  Results of published, randomized controlled trials comparing sevoflurane and desflurane were pooled to measure differences in times until patients obeyed commands, were extubated, were oriented, were discharged from the postanesthesia care unit (PACU), and were ready to be discharged to home, as well as the occurrence of postoperative nausea and vomiting (PONV).
  
  
  METHODS
  We reviewed all randomized clinical trials in MEDLINE through December 18, 2003, with a title or abstract containing the words sevoflurane and desflurane. Two reviewers independently extracted study data from papers that met inclusion criteria. Endpoints were pooled using random-effects meta-analysis.
  
  
  RESULTS
  Twenty-two reports of 25 studies (3 reports each described 2 studies) met our inclusion criteria. A total of 746 patients received sevoflurane, and 752 received desflurane. Patients receiving desflurane recovered 1-2 minutes quicker in the operating room than patients receiving sevoflurane. They obeyed commands 1.7 minutes sooner (p < 0.001; 95% confidence interval [CI], 0.7-2.7 minutes), were extubated 1.3 minutes sooner (p = 0.003; 95% CI, 0.4-2.2 minutes), and were oriented 1.8 minutes sooner (p < 0.001; 95% CI, 0.7-2.9 minutes). No significant differences were detected in the phase I or II PACU recovery times or in the rate of PONV.
  
  
  CONCLUSIONS
  Meta-analysis of studies in which the duration of anesthesia was up to 3.1 hours indicated that patients receiving either desflurane or sevoflurane did not have significant differences in PACU time or PONV frequency. Patients receiving desflurane followed commands, were extubated, and were oriented 1.0-1.2 minutes earlier than patients receiving sevoflurane.
authors.affiliation: Departments of Anesthesia and Health Research and Policy, Stanford University School of Medicine, Stanford, CA 94305-5640, USA. amaca@stanford.edu
authors.forename: Alex
authors.initials: A
authors.lastname: Macario
authors.forename: Frankin
authors.initials: F
authors.lastname: Dexter
authors.forename: David
authors.initials: D
authors.lastname: Lubarsky
mesh_terms: D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D002675:Child, Preschool; D000077335:Desflurane; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D008738:Methyl Ethers / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D008875:Middle Aged; D011182:Postoperative Care / Q000706:statistics & numerical data; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D011997:Recovery Room; D000077149:Sevoflurane; D013514:Surgical Procedures, Operative / Q000379:methods; D013997:Time Factors
chemical_list: D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane