Early postoperative recovery after intracranial surgical procedures. Comparison of the effects of sevoflurane and desflurane

Gökçek, Erhan; Kaydu, Ayhan; Akdemir, Mehmet Salim; Akıl, Ferit; Akıncı, İbrahim Özkan

doi:10.1590/s0102-865020160090000010

Cited by 10 publications

(20 citation statements)

References 32 publications

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“…This was supported by the previous investigations. [22,23] This discrepancy of time reported in the previous studies [22,23] might be attributed to a longer anesthesia times compared to that reported in our study. Moreover, in the previous study, remifentanil was used for intraoperative analgesia whose metabolism is instantaneous as compared to fentanyl which was used in our study.…”

Section: Discussioncontrasting

confidence: 84%

Randomized trial to compare plasma glucose trends in patients undergoing surgery for supratentorial gliomas under maintenance of sevoflurane, desflurane, and propofol

et al. 2020

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Background: Anesthetic agents influence the glycemic response by affecting the neuroendocrine surgical response or directly modifying pancreatic insulin release. Due to chances of neuronal damage, intraoperative hyperglycemia and hypoglycemia both are detrimental for patients undergoing neurosurgeries. Inhalational (sevoflurane and desflurane) and intravenous (propofol) agents have been found to raise intraoperative glucose levels in nonneurological surgeries. Aim: We aimed to compare the intraoperative glucose levels in supratentorial glioma surgeries under the maintenance of three anesthetic agents such as sevoflurane, desflurane, and propofol. Materials and Methods: This randomized trial was conducted with 90 nondiabetic adults with supratentorial glioma. Thirty patients were allocated randomly to the three groups receiving sevoflurane, desflurane, and propofol. Baseline and hourly plasma glucose levels were recorded. Postoperatively, the time required to achieve an Aldrete score of 9 and complications were assessed. Results: Baseline plasma glucose levels were 111.23 ± 11.67, 109.47 ± 19.75, and 111.7 ± 13.88 mg/dL ( P = 0.84) in sevoflurance, desflurane, and propofol group, respectively. All of them showed an elevation of plasma glucose in relation to the time of surgery with variable trends. In the 4 th and 5 th h, the elevations in the inhalational groups (sevoflurane and desflurane) were significantly higher than the propofol group ( P = 0.003 and 0.002, respectively). The time for achieving Aldrete's score of 9 was higher in the propofol group ( P < 0.0001). No differences were observed in the duration of hospital stay or complications. Conclusions: Maintenance of anesthesia in nondiabetic patients showed clinically modest rise of plasma glucose which is higher in patients under sevoflurane and desflurane than under propofol. However, the immediate recovery was faster with inhalational agents compared to propofol-based anesthesia.

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Section: Discussioncontrasting

confidence: 84%

Randomized trial to compare plasma glucose trends in patients undergoing surgery for supratentorial gliomas under maintenance of sevoflurane, desflurane, and propofol

et al. 2020

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“…The results of previous studies comparing the extubation time of desflurane with propofol-based TIVA or sevoflurane have been controversial. For the studies comparing the desflurane with sevoflurane, most observed a more rapid recovery from desflurane [ 4 , 13 , 14 ], whereas others comparing desflurane with TIVA found no superiority of desflurane [ 1 , 15 , 16 ]. Sevoflurane and desflurane are both widely used inhalation anesthetics, while desflurane has been shown to be associated with shorter emergence time and earlier recovery time in several studies [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Desflurane, with the lowest blood-gas partition coefficient of the available halogenated agents, has been suggested be a potential for rapid recovery after discontinuation [ 4 ]. Previous meta-analysis found that desflurane reduced the extubation time by 34% relative to isoflurane and by 25% relative to sevoflurane [ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Early postoperative recovery in operating room after desflurane anesthesia combined with Bispectral index (BIS) monitoring and warming in lengthy abdominal surgery: a randomized controlled study

Zhang

et al. 2018

BMC Anesthesiol

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BackgroundThis study aimed to determine whether the use of desflurane (DES) anesthesia combined with bispectral index (BIS) monitoring and warming is effective in reducing anesthesia-controlled operating room time (ACT) in patients undergoing lengthy abdominal surgery.MethodsSeventy patients, 40 years of age or older, undergoing abdominal surgery expected to last three to five hours were randomly assigned to the DES group (n = 35) or the control group (n = 35). Patients in the DES group were maintained with desflurane anesthesia and received BIS monitoring and warming. Patients in the control group were given non-desflurane anesthesia for maintenance, and the usage of BIS monitoring and warming were not mandatory and determined by anesthesia care providers. Early postoperative recovery times were recorded.ResultsThe times to extubation (8.8 ± 8.5 vs 14.7 ± 13.7 min, P = 0.035), eye opening (8.4 ± 8.6 vs 14.4 ± 13.4 min, P = 0.028), responds on command (8.2 ± 8.5 vs 14.4 ± 13.0 min, P = 0.022), and the ACT (23.8 ± 11.4 vs 32.7 ± 15.4 min, P = 0.009) were significantly less in the DES group than that in the control group. The postanesthesia care unit (PACU) length of stay, incidence of prolonged extubation, and surgeon and anesthesiologist satisfaction were similar in two groups. Also, the result of multivariable linear regressions showed that patients who were younger, female, lower BMI and non-DES anesthesia regimen resulted in prolonged extubation.ConclusionsDesflurane anesthesia combined with BIS monitoring and warming is associated with early postoperative recovery in lengthy abdominal surgery.Trial registrationChiCTR-INR-17013333. Date of registration: November 11, 2017.

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“…Similarly, several studies (9,15) also observed Modified Aldrete Score as criteria for intermediate recovery. In 2016, Erhan Gökçek et al (16) used Modified Aldrete Score in their study to assess intermediate recovery. The time to achieve Modified Aldrete Score of 9 was significantly less in desflurane group as compared to sevoflurane group.…”

Section: Discussionmentioning

confidence: 99%

Clinical evaluation of Desflurane versus Sevoflurane in laparoscopic surgery

Ankalwar¹

2017

JMSCR

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Aims and Objectives:The present study was undertaken to evaluate desflurane in terms of hemodynamic stability, recovery profile and perioperative complications and compare results of desflurane with routinely used sevoflurane for laparoscopic surgery. Methods: Eighty patients of either sex, scheduled for laparoscopic surgeries under general anaesthesia were randomly allocated into two groups i.e. Group D and Group S. Patients of Group D received desflurane and of Group S received sevoflurane as an inhalational anesthetic. The intraoperative haemodynamic parameters, recovery characteristics and postoperative complications were observed and compared between two groups. Results: Intraoperative MAP and HR did not differ between the two groups (P > 0.05). Desflurane led to faster early recovery but the intermediate recovery was similar in both the groups. The incidence of postoperative complications was comparable in both the groups but incidence of coughing was more in desflurane group which was self limiting. Conclusion: Desflurane can be used as an effective alternative to sevoflurane for maintenance of anaesthesia in laparoscopic procedures.

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Early postoperative recovery after intracranial surgical procedures. Comparison of the effects of sevoflurane and desflurane

Cited by 10 publications

References 32 publications

Randomized trial to compare plasma glucose trends in patients undergoing surgery for supratentorial gliomas under maintenance of sevoflurane, desflurane, and propofol

Randomized trial to compare plasma glucose trends in patients undergoing surgery for supratentorial gliomas under maintenance of sevoflurane, desflurane, and propofol

Early postoperative recovery in operating room after desflurane anesthesia combined with Bispectral index (BIS) monitoring and warming in lengthy abdominal surgery: a randomized controlled study

Clinical evaluation of Desflurane versus Sevoflurane in laparoscopic surgery

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