DESFLURANE VERSUS PROPOFOL MAINTENANCE FOR OUTPATIENT LAPAROSCOPIC CHOLECYSTECTOMY

Background: The aims of the study were to evaluate costs and clinical characteristics of desflurane-based anaesthetic maintenance versus pro pofol for outpatient cholecystectomy. Methods: All 60 patients receive d ketamine 0.2 mg kg(-1), fentanyl 2 mu g kg(-1) and propofol 2 mg kg( -1) for induction. Ketorolac 0.4 mg kg(-1) and ondansetron 0.05 mg kg( -1) +droperidol 20 mu g kg(-1) was given as prophylaxis for postoperat ive pain and emesis, respectively The patients were randomly assigned into Group P with propofol maintenance and opioid supplements, or Grou p D with desflurane in a low-flow circuit system. Results: All the pat ients were successfully discharged within 8 h without any serious comp lications. Emergence from anaesthesia was more rapid after desflurane; they opened their eyes and stated date of birth at mean 6.4 and 8.4 m in respectively, compared with 9.6 and 12 min in the propofol group (P <0.05). Nausea and pain were more frequent in Group D, 40% and 80% res pectively; versus 17% and 50% in Group P (P<0.05). By telephone interv iew at 24 h and 7 d after the procedure, there was no major difference between the groups. With desflurane, drug casts per case were 10 $ lo wer than with propofol. Conclusion: We conclude that desflurane is che aper and has a more rapid emergence than propofol for outpatient chole cystectomy. However, propofol results in less pain and nausea in the r ecovery unit. Despite ondansetron and droperidol prophylaxis, there wa s still a substantial amount of nausea and vomiting after desflurane. (C) Acta Anaesthesiologica Scandinavica 42 (1998).