Isoflurane, desflurane and sevoflurane for carotid endarterectomy

Abstract

SummaryAfter carotid endarterectomy under general anaesthesia, the rapid elimination of desflurane and sevoflurane may allow earlier postoperative neurological assessment than after the use of isoflurane. However, desflurane may be associated with tachycardia and hypertension and may therefore increase cardiovascular risk. We investigated haemodynamic and recovery characteristics in patients scheduled for carotid endarterectomy who were anaesthetised with isoflurane, sevoflurane or desflurane. No significant peri-operative differences were noted in cardiac index or ST segment analysis. The times to extubation, movement on command and consciousness were shorter after desflurane and sevoflurane than after isoflurane anaesthesia. Postoperative pain, nausea, vomiting and shivering were similar in the three study groups.

Pharmacoeconomics of Volatile Inhalational Anaesthetic Agents: An 11-Year Retrospective Analysis

“…Studies comparing rapidity of awakening from desflurane versus sevoflurane report more conflicting results. Many studies suggest no differences in recovery profiles 22,32,35,36 , but others report a more rapid awakening with desflurane 29,[37][38][39][40][41][42] . It may be argued that for patients undergoing longer procedures, in order to balance the cost of using desflurane or sevoflurane with their pharmacokinetic benefits of quicker recovery times, the cheaper isoflurane should be used for maintenance of anaesthesia, changing to desflurane or sevoflurane towards the end.…”

The impact of isoflurane, desflurane, or sevoflurane on the frequency and severity of postoperative nausea and vomiting after lumbar disc surgery

“…There are few direct comparisons between the three inhalation anesthetics with regard to PONV [19][20][21]. These studies mainly investigate the recovery characteristics of patients receiving the three inhalation anesthetics, so that PONV was not the primary endpoint.…”

Sevoflurane for interventional neuroradiology procedures is associated with more rapid early recovery than propofol

“…Sevoflurane has been shown to have a pharmacological profile suitable for neuroanesthesia, 1 and has been associated with a short recovery profile, which supports its use for neuroanesthesia. 2 Propofol is also associated with a rapid recovery and is suitable for use as a neuroanesthetic agent. 3 This study is the first to compare recovery from sevoflurane and propofol for maintenance anesthesia during neurological procedures of one to five hours duration, for which the speed and quality of recovery are critical.…”