Comparison of Induction, Maintenance and Recovery Characteristics of Sevoflurane - N2o and Propofol - Sevoflurane - N 2o With Propofol - Isoflurane - N2o

Abstract

BACKGROUND: Rapid redistribution of the intravenous induction agent could lead to lightening of the plane of anesthesia before adequate depth is attained with the inhalational agent. This has promoted the rediscovery of single agent anesthesia, which avoids problems associated with transition phase. The aim of the study was to compare induction, maintenance and recovery with sevoflurane anesthesia from propofol and isoflurane anesthesia when administered with nitrous oxide to patients undergoing laparoscopic surgeries. METHODS: Sixty consenting patients of ASA physical status I or II aged between 20-55yrs of either sex scheduled for elective laparoscopic surgeries were randomly assigned to receive either I propofol for induction of anesthesia and isoflurane-nitrous oxide for maintenance (control), II propofol for induction and sevoflurane-nitrous oxide for maintenance, or III sevoflurane-nitrous oxide for induction and maintenance of anesthesia. Induction, maintenance and recovery characteristics were noted and compared between groups. RESULTS: Inhalational induction with sevoflurane-nitrous oxide was relatively prolonged (106±14s) and smooth without any episodes of coughing or laryngospasm. There were no untoward hemodynamic changes. Post induction mean arterial pressure (MAP) values were less in the groups where propofol was used (77.83±5.29mmHg and 78.96±5.58mm Hg in groups I and II respectively) as compared to the group in which sevoflurane-nitrous oxide was used for induction (83.16±4.70mmHg). Recovery time in the isoflurane-nitrous oxide group was much longer (7:47±0:47minutes) compared to the sevoflurane-nitrous oxide groups (4:41±0:26minutes and 4:37±0:26minutes in groups II and III respectively). STATISTICAL ANALYSIS: Data are expressed as mean ± standard deviation. Data were analyzed using analysis of variance and chi-square test. CONCLUSION: Induction of anesthesia with sevoflurane-nitrous oxide was relatively prolonged without any side effects. Patients were hemodynamically stable throughout in all groups. Emergence and recovery after maintenance with sevoflurane-nitrous oxide was significantly faster than after isoflurane-nitrous oxide anesthesia.