DESFLURANE IS NOT ASSOCIATED WITH FASTER OPERATING-ROOM EXIT TIMES INOUTPATIENTS

Study Objective: To determine the influence of anesthetic technique an d primary drug on operating room (OR) exit time (time between end of s urgery until time patient exists tile OR) after addition of desflurane to the hospital formulary. Design: Prospective study. Setting: Ambula tory surgery unit of a university hospital. Patients: 1,568 outpatient s requiring anesthesia. Interventions: Addition of desflurane to the h ospital formulary and substitution of desflurane vaporizers for enflur ane vaporizers in the ambulatory surgery unit. Measurements and Main R esults: The following information was recorded for all anesthetic enco unters over a six-month time interval: demographics, duration of surge ry, primary anesthetic technique, primary anesthetic drug; and exit ti mes. General anesthesia was used in 907 patients [desflurane: 209 pati ents, isoflurane: 429 patients, halothane: 192 patients, propofol: 72 patients, other intravenous (IV): 5 patients], major conduction anesth esia (spinal and epidural) in 43 patients, peripheral nerve blocks in 90 patients, and IV sedation in 528 patients. The exit time was signif icantly greater (p < 0.05) in patients who received general anesthesia (mean +/- SEM 14 +/- 0.2 min) compared with spinal/epidural (8 +/- 0. 7 min), nerve blocks (8 +/- 0.4 min) and IV sedation (7 +/- 0.2 min). Exit times were longer in older patients receiving general anesthesia (exit time = 12.3 +/- 0.04 x age, SE = 6.7 min, p < 0.0009), whereas e xit times were shorter in older individuals receiving IV sedation (exi t time = 8.97 - 0.038 x age, SE = 3.6 min, p < 0.0001). For patients r eceiving IV sedation, exit times were shorter as duration of surgery i ncreased (exit time = 7.86 - 0.015 x duration of surgery, SE = 3.6 min , p < 0.0002). Primary aesthetic drug did not affect exit times. Concl usion: Regional anesthesia and IV sedation were associated with faster OR exit times compared with general anesthesia. Despite desflurane's shorter elimination kinetics and recovery characteristics, use of this drug did not result in shorter exit times.