Postoperative recovery after desflurane, propofol, or isoflurane anesthesia among morbidly obese patients: A prospective, randomized study

Recovery from anesthesia might be compromised in obese patients. Because of its pharmacological properties, desflurane might allow rapid postoperative recovery for these patients. We compared postoperative recovery for 36 obe se patients randomized to receive either desflurane, propofol, or isofluran e to maintain anesthesia during laparoscopic gastroplasties. Anesthesia was induced with propofol and succinylcholine IV and was maintained with rocur onium, alfentanil, inhaled nitrous oxide, and the study drug. Immediate rec overy (i.e., times from the discontinuation of anesthesia to tracheal extub ation, eye opening, and the ability to state one's name) was measured. At t he time of postanesthesia care unit (PACU) admission, arterial saturation a nd the ability of patients to move were recorded. In the PACU, intermediate recovery was measured by using sedation and psychometric evaluations, 30, 60, and 120 min postoperatively. Data were compared between groups by using the Kruskal-Wallis and chi(2) tests. Results were reported as means +/- SD . P < 0.05, compared with desflurane, was considered significant. Immediate recovery occurred faster, and was more consistent, after desflurane than a fter propofol or isoflurane (times to extubation were 6 +/- 1 min, 13 +/- 8 min [P < 0.05, compared with desflurane], and 12 +/- 6 min [P < 0.05, comp ared with desflurane], respectively). At PACU admission, SpO(2) values were significantly higher and patient mobility was significantly better after d esflurane than after isoflurane or propofol Sedation was significantly less pronounced with desflurane at 30 and 120 min postoperatively. In morbidly obese patients, postoperative immediate and intermediate recoveries are mor e rapid after desflurane than after propofol or isoflurane anesthesia. This advantage of desflurane persists at least for 2 h after surgery and is ass ociated with both an improvement in patient mobility and a reduced incidenc e of postoperative desaturation.