Desflurane vs. sevoflurane as the main inhaled anaesthetic for spontaneous breathing via a laryngeal mask for varicose vein day surgery: a prospective randomized study.
BACKGROUND
Sevoflurane has become widely used in day surgery; however, desflurane may be a valuable alternative even in this setting. This study compares emergence from anaesthesia for day surgery with spontaneous breathing using either desflurane or sevoflurane.


METHODS
This prospective, randomized, single-blinded study examined 70 ASA III patients undergoing elective ambulatory varicose vein surgery. Primary endpoint was emergence time (cessation of anaesthetic gas to communicating). Secondary endpoints included post-operative pain, nausea, time to discharge, and patient satisfaction. Patients were anaesthetized according to a standardized protocol including multimodal analgesia and antiemetic therapy and were randomized to receive sevoflurane or desflurane as the main anaesthetic while breathing spontaneously through a laryngeal mask airway. Fresh gas flow was oxygen in air 1 : 2 l/min.


RESULTS
Intra-operative anaesthesia was uneventful apart from airway irritation observed in 5/35 desflurane and 1/35 sevoflurane patients. Emergence was 25-40% faster in patients anaesthetized with desflurane. Pain and post-operative nausea and vomiting (PONV) were equally infrequent in both groups. Overall, patient satisfaction was high with no difference between the groups.


CONCLUSIONS
Desflurane is associated with a faster emergence with no differences during the post-operative course except a somewhat higher incidence of airway irritation.
Saros
G B
GB
Department of Anaesthesiology, Sabbatsberg Hospital, Stockholm, Sweden.
Doolke
A
A
Anderson
R E
RE
Jakobsson
J G
JG
D000328:Adult; D000556:Ambulatory Surgical Procedures; D018685:Anesthetics, Inhalation; D000077335:Desflurane; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives*; D017214:Laryngeal Masks; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D011184:Postoperative Period; D011446:Prospective Studies; D015656:Respiratory Mechanics; D000077149:Sevoflurane; D016037:Single-Blind Method; D014648:Varicose Veins / Q000601:surgery*; D014656:Vascular Surgical Procedures
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane