A MULTICENTER COMPARISON OF MAINTENANCE AND RECOVERY WITH SEVOFLURANEOR ISOFLURANE FOR ADULT AMBULATORY ANESTHESIA

Sevoflurane was compared with isoflurane in 246 adult ASA class I-III patients undergoing ambulatory surgery. After administration of midazo lam 1-2 mg and fentanyl 1 mu g/kg, anesthesia was induced with propofo l 2 mg/kg and maintained with either sevoflurane of isoflurane in 60% nitrous oxide to maintain arterial blood pressure at +/- 20% of baseli ne. Fresh gas flows were 10 L/min during induction and 5 L/min during maintenance. Times to eye opening, command response, orientation, and ability to sit without nausea and/or dizziness were significantly fast er after sevoflurane. Significantly more sevoflurane patients met Phas e 1 of postanesthesia care unit (PACU) Aldrete recovery criteria (grea ter than or equal to 8) at arrival, 95% vs 81%. Also, significantly mo re sevoflurane patients were able to complete psychomotor recovery tes ts during the first 60 min postanesthesia. Discharge times were not di fferent. Sevoflurane patients had significantly lower incidences of po stoperative somnolence (15% vs 26%) and of nausea both in the PACU (36 % vs 51%) and in the 24-h postdischarge period (9% us 24%). Patient sa tisfaction was high overall (sevoflurane 97%, isoflurane 93%). We conc lude that sevoflurane is a useful inhaled anesthetic for maintenance o f ambulatory anesthesia.