DESFLURANE VERSUS PROPOFOL ANESTHESIA - A COMPARATIVE-ANALYSIS IN OUTPATIENTS

This study compares the induction, hemodynamic, and recovery character istics of a general anesthetic with desflurane to one with propofol. S ixty outpatients presenting for orthopedic surgery received either a p ropofol induction of anesthesia followed by desflurane and nitrous oxi de (Group 1), a propofol induction followed by propofol infusion and n itrous oxide (Group 2), a desflurane and nitrous oxide induction and m aintenance (Group 3), or a desflurane induction and maintenance (Group 4). The quality of induction was inferior in Groups 3 and 4 with more breath-holding and excitation than in Groups 1 and 2. However, there was a more rapid emergence in Group 4 patients than any of the other g roups. Group 4 patients were able to say their names (5.6 +/- 2.0 min vs 10.3 +/- 3.3 min, 8.6 +/- 3.1 min, and 9.3 +/- 1.5 min for Groups 1 , 2, and 3, respectively) sooner after the discontinuation of anesthes ia. Nonetheless, intermediate recovery was similar in Groups 2 and 4 b eing numerically but not statistically more rapid than in Groups 1 and 3. This pattern of intermediate recovery was also demonstrated by psy chomotor function test results. Although there was no difference betwe en the groups in postoperative narcotic requirement, more patients in Group 3 vomited (50%) than in either Group 2 (0%) or Group 4 (12.5%). Hemodynamically, the anesthetics were very similar. Although desfluran e was a difficult drug to use for induction of anesthesia, this study demonstrates that desflurane is a suitable maintenance anesthetic for ambulatory surgery because it provides a rapid awakening and an interm ediate recovery similar to propofol.