title: The effect of low-flow sevoflurane and desflurane on pulmonary mechanics during laparoscopic surgery.
abstract: BACKGROUND
  This study was designed to investigate the effects of inhaled anesthetic agents on respiratory mechanics with low flow anesthesia in laparoscopic abdominal surgery. Two inhaled anesthetics, desflurane and sevoflurane, have a lower solubility in blood and tissues than all previous volatile anesthetics, and have become the preferred volatile anesthetics for routine surgical procedures.
  
  
  METHODS
  Twenty-six patients were examined. Patients were randomly assigned to two groups, to receive sevoflurane (n = 13) or desflurane (n = 13). Tidal volume and ventilation rate were kept unchanged throughout the operation. Intra-abdominal pressure was kept constant at the level of 12 mm Hg. Respiratory mechanics such as peak inspiratory pressure (PIP), respiratory resistance (Rr), and dynamic compliance (Cdyn) measurements were recorded by a Datex-Ohmeda respiratory device (Datex-Ohmeda, Finland) at four timepoints: 5 minutes after mechanical ventilation started (T1), after insufflation of the peritoneum (T2), in the 30-degree Trendelenburg position (T3), and after desufflation of the peritoneum (T4).
  
  
  RESULTS
  In our study, desflurane caused a statistically significant increase in PIP and Rr and decrease in C(dyn). When the two groups were compared, Rr values in the deslurane group showed significant increases at T2, T3, and T4 compared to the sevoflurane group (P < 0.05). These values did not change in the sevoflurane group, while PIP significantly increased at T2, T3, and T4 after desufflation in the desflurane group (P < 0.05). Cdyn values decreased significantly at all 4 timepoints in the desflurane group compared to the sevoflurane group (P < 0.05).
  
  
  CONCLUSIONS
  We concluded that respiratory mechanics were affected by desflurane with low flow anesthesia in patients undergoing laparoscopic abdominal surgery. No significant influence on respiratory mechanics was seen with sevoflurane anesthesia.
authors.affiliation: Department of Anesthesiology and Re-animation, Kocatepe University, Afyon, Turkey. yasarsivaci@hotmail.com
authors.forename: Remziye
authors.initials: R
authors.lastname: Sivaci
authors.forename: Ayse
authors.initials: A
authors.lastname: Orman
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yilmazer
authors.forename: Sezgin
authors.initials: S
authors.lastname: Yilmaz
authors.forename: Hülya
authors.initials: H
authors.lastname: Ellidokuz
authors.forename: Coskun
authors.initials: C
authors.lastname: Polat
mesh_terms: D000328:Adult; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D000077335:Desflurane; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage / Q000031:analogs & derivatives*; D010535:Laparoscopy; D008170:Lung Compliance / Q000187:drug effects; D008738:Methyl Ethers / Q000008:administration & dosage*; D015656:Respiratory Mechanics / Q000187:drug effects*; D000077149:Sevoflurane; D013990:Tidal Volume / Q000187:drug effects
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane