RECOVERY FROM SEVOFLURANE AND ISOFLURANE ANESTHESIA AFTER OUTPATIENT GYNECOLOGICAL LAPAROSCOPY

As the low blood solubility (blood gas partition coefficient 0.69) of sevoflurane suggests a rapid emergence from anaesthesia, recovery from sevoflurane anaesthesia was compared to isoflurane in outpatient gyna ecological laparoscopy. Fifty ASA I or II, consenting women participat ed in a randomised, controlled and single blind study. The patients re ceived, after induction of anaesthesia with propofol, either sevoflura ne or isoflurane, both with 67% nitrous oxide in oxygen, for maintenan ce of anaesthesia. The study drug was administered at 1 MAC (end tidal concentration 0.6% for sevoflurane and 0.5% for isoflurane) but adjus ted in 0.5 MAC steps, if clinically indicated. Before the end of surge ry the end tidal concentration of the study drug was reduced to 0.5 iL MAC. Recovery assessments were made from the time anaesthetic gases w ere discontinued. The subjects were able to open eyes in 2.3 (0.8-7.0) min and 4.1 (2.0-6.8) min, orientate in 2.8 (1.0-6.8) min and 4.7 (2. 2-8.3) min and follow orders in 2.6 (0.7-6.8) min and 4.3 (1.2-7.3) mi n, in the sevoflurane and isoflurane groups, respectively (P<0.05) [me dian (range)]. Walking was achieved in 72 (24-464) min and 66 (35-134) ) min, tolerance of oral fluids in 37 (15-88) min and 35 (45-161) min and voiding in 262 (96-459) min and 217 (52-591) min in the sevofluran e and isoflurane groups, respectively (NS). Overall home readiness was achieved in 281 (96-708) min after sevoflurane group and 242 (96-591) min after isoflurane (NS). Postoperative nausea and vomiting was comm on in both groups (55% for sevoflurane and 15% for isoflurane) and con tributed to three subjects in the sevoflurane group and four in the is oflurane group being admitted to hospital.