Similar recovery from bispectral index-titrated isoflurane and sevoflurane anesthesia after outpatient gynecological surgery.
OBJECTIVE
To test the hypothesis that the recovery of gynecological day-case patients is equally fast after isoflurane and sevoflurane anesthesia, when administration of the inhaled agent is adjusted by monitoring the bispectral index (BIS).


METHODS
Prospective, randomized, controlled, single-blinded clinical study.


METHODS
University-affiliated women's hospital.


METHODS
120 adult female patients, ASA physical status I or II, scheduled for ambulatory surgery under general anesthesia.


METHODS
Patients were randomized to receive either isoflurane or sevoflurane as the maintenance anesthetic. BIS values were titrated to remain between 50 and 60 during the maintenance of anesthesia by adjusting the inspired concentration of the inhaled agent. Administration of the inhaled agent was discontinued abruptly at the end of the procedure.


METHODS
The times to achieving several recovery end points were recorded. The main outcome parameter was the time to home-readiness. In the postoperative care unit, sedation was evaluated with the digit-symbol substitution test. The degree of pain and nausea was evaluated on the visual analog scale.


RESULTS
There were no statistically significant differences in the times to home-readiness, or in any other parameters of early or intermediate recovery between the 2 groups. The degrees of sedation, pain, and nausea in the postoperative care unit were similar in the 2 groups.


CONCLUSIONS
Isoflurane and sevoflurane are equally acceptable maintenance anesthetics in terms of the speed and quality of recovery in gynecological ambulatory surgery patients when the dose of the inhaled agent is adjusted to achieve a BIS between 50 and 60.
Seitsonen
Elina R J
ER
Department of Anesthesia and Intensive Care, Helsinki University Hospital, Helsinki, Finland. elina.seitsonen@hus.fi
Yli-Hankala
Arvi M
AM
Korttila
Kari T
KT
D000328:Adult; D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation; D004569:Electroencephalography; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007530:Isoflurane; D008738:Methyl Ethers; D010149:Postoperative Pain; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D007530:Isoflurane