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Recovery characteristics of sevoflurane‐ or propofol‐based anaesthesia for day‐care surgery
Author(s) -
RÆDER J.,
GUPTA A.,
PEDERSEN F. M.
Publication year - 1997
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1997.tb04825.x
Subject(s) - medicine , propofol , sevoflurane , anesthesia , fentanyl , vomiting , nausea , postoperative nausea and vomiting , bradycardia , general anaesthesia , surgery , heart rate , blood pressure , radiology
Background: Sevoflurane has a low blood‐gas partition coefficient resulting in a rapid recovery. Few studies have examined the maintenance and recovery characteristics of sevoflurane compared with propofol in a standardized outpatient population. Methods: The study was a multicentre study performed in 10 centres. One hundred and sixty‐nine elective outpatients due for knee‐arthroscopy received 100 mg diclofenac rectally as pain prophylaxis prior to induction of general anaesthesia with fentanyl 1.0–1.5 μg/kg+propofol 2.0–2.5 mg/kg iv. Anaesthesia was maintained with 60% nitrous oxide in oxygen through a laryngeal mask and continuous administration of either: sevoflurane (group S) or propofol infusion (group P) in order to maintain stable haemodynamics. Data of postoperative function and side‐effects were collected in a double‐blind design, including a patient interview after 24 h. Results: The sevoflurane patients had a significantly faster emergence from anaesthesia, with response to commands at 6.9±0.4 min versus 8.2±0.4 min in the propofol group ( P < 0.05, mean±SD). At 15 min after surgery, group S had a better score in the digit symbol substitution test and felt less confused in a visual analogue scale test compared with group P (P<0.05). Peroperative bradycardia, nausea and vomiting and late postoperative dizziness were more common in group S. In the sevoflurane group, 32% had nausea or vomiting in the 24 h observation period compared with 18% for propofol ( P < 0.05). There was no difference between group S and group P in postoperative pain, eligibility for recovery room discharge (75±12 versus 70±11 min) or home‐readiness (155±12 versus 143±11 min). Conclusion: Maintenance of anaesthesia with sevoflurane results in a more rapid emergence, but a higher incidence of nausea and vomiting compared with propofol. The side‐effects were minor in our study, and did not result in any difference in time to discharge from the recovery ward or the hospital.