ANESTHESIA DURING LAPAROSCOPIC GYNECOLOGICAL SURGERY - A COMPARISON BETWEEN DESFLURANE AND ISOFLURANE

Desflurane is a new inhalation anaesthetic with a low blood/gas solubi lity which should allow a fast emergence from anaesthesia. In a prospe ctive open randomized study, desflurane was compared with isoflurane p aying special attention to recovery and the quality of the post-operat ive period. The occurrence of pain and post-operative nausea and vomit ing (PONV) was recorded during the first 20 post-operative hours. Seve nty women ASA Grade I-II scheduled for elective gynaecological laparos copic procedures were studied. Patients receiving desflurane were extu bated earlier than patients receiving isoflurane, 5 +/- 1 and 9 +/- 1 min respectively (P<0.05) and the patients anaesthetized with desflura ne were able to tell their name and date on average 5 min earlier than those who had received isoflurane; however, time in the recovery room was the same for both groups of patients. Twenty-two of 35 patients r eceiving desflurane, and 18 of 35 receiving isoflurane required analge sia. PONV was recorded in 18 patients anaesthetized with desflurane an d 12 patients anaesthetized with isoflurane. In both groups PONV was m ore frequently observed in patients after leaving the recovery room. P ONV in the recovery room was associated with a delayed discharge, 139 vs. 114 min respectively. Desflurane seems to be an useful alternative to isoflurane for laparoscopic procedures.