Isoflurane v Fentanyl for Outpatient Laparoscopy

Abstract

Isoflurane and fentanyl have been compared as anaesthetic agents for outpatient laparoscopy. In 50 female patients anaesthesia was induced with thiopentone and maintained with nitrous oxide 66% in oxygen combined with either isoflurane 1-2% or fentanyl 0.3 mg according to a randomized list. Suxamethonium was used to facilitate intubation and for further muscle relaxation. Immediate recovery from anaesthesia was assessed by eye opening and time before giving the date of birth. Additional observations made hourly for 4 h were: nausea or vomiting; clinical assessment of wakefulness; psychic or motor agitation; antiemetic or analgesic drugs given; reaction time; respiratory depression. Immediate recovery was more rapid in the fentanyl group (P less than 0.05). Reaction times in the isoflurane patients returned to control by 3 h, whereas the fentanyl patients were 10% slower than control at 4 h (P less than 0.05 at 2 h, 3 h, 4 h). Nausea and vomiting were more frequent in the fentanyl group, and four of the fentanyl patients required naloxone. Both anaesthetic techniques provided satisfactory operating conditions, but isoflurane appeared to provide a better recovery with less side effects than fentanyl.

Premedication before elective breast surgery, a comparison between ketobemidone and midazolam

“…Postoperative nausea and vomiting continue to be common in spite of advances in the techniques used in general anaesthesia. This is especially true in female patients (19,20). The frequency of postoperative emetic sequelae varies widely between different studies; figures as high as 83% have been reported (21).…”

“…It is well known that fentanyl anaesthesia is associated with a high frequency of postoperative nausea (20,21). The differences between different inhalation anaesthetics are controversial (4,25).…”