SEVOFLURANE FOR OUTPATIENT ANESTHESIA - A COMPARISON WITH PROPOFOL

Three different anesthetic techniques were compared in 146 healthy out patients undergoing ambulatory surgery. In Groups I and II, anesthesia was induced with propofol (1.5-2.0 mg/kg, intravenously [iv]) and mai ntained with nitrous oxide (N2O) 60% in oxygen and either a propofol i nfusion, 75-160 mu g . kg(-1). min(-1) IV, or sevoflurane, 1%-2% end-t idal, respectively. In Group III, anesthesia was induced and maintaine d with sevoflurane, 1%-4% end-tidal and N2O 60% in oxygen. In addition to 60% N2O in oxygen at a total gas flow of 3 L/min, all patients rec eived fentanyl, 2-3 mu g/kg IV, and vecuronium, 0.1 mg/kg IV. IV induc tion of anesthesia with propofol (90 +/- 53 s and 94 +/- 48 s in Group s I and II, respectively) was significantly faster than inhalation ind uction with sevoflurane (153 +/- 100 s). There were no significant dif ferences in the incidence of coughing, airway irritation, or laryngosp asm during induction of anesthesia. Although the mean arterial blood p ressure values were similar in all three groups, the use of sevofluran e was associated with consistently lower heart rate values during the early maintenance period. Early and intermediate recovery times were t he same in all three treatment groups. The use of sevoflurane for indu ction and/or maintenance of anesthesia was associated with a higher in cidence of postoperative emetic sequelae compared with propofol. Final ly, the times at which patients were considered ''fit for discharge'' and the actual discharge times were similar in all three groups. Sevof lurane is an acceptable alternative to propofol for induction and main tenance of out-patient anesthesia.