Desflurane does not accelerate recovery from operations of short duration: a practice audit

Desflurane, a newer inhalation anesthetic agent, has been promoted as a superior drug because patients will awaken sooner after anesthesia. This has only been proven in operations of long duration (i.e., more than one hour). We assessed our experience using desflurane in short out-patient surgery with a retrospective analysis of a single surgeon's elective laparoscopic cholecystectomy patients.

With Institutional consent, we performed a retrospective comparison of the postoperative recovery of patients who received desflurane/air/oxygen to historical control patients who received isoflurane/N2O/oxygen.

Patient preoperative characteristics were similar in the two groups. Duration of surgery and the time from the end of surgery to patient leaving the operating room for the desflurane and isoflurane/N2O groups were (in minutes) 42.7 +/- 13.5 and 9.6 +/- 4.6 vs 47.2 +/- 15.1 and 8.5 +/- 4.1 respectively (P = NS). Total Aldrete scores upon presentation to the postanesthesia care unit (PACU) were 8.1 +/- 1.4 and 7.9 +/- 1.8 for the two groups respectively (P = NS). The percentage of patients who arrived in the PACU with consciousness scores of 2, 1, 0 for the desflurane and isoflurane/N2O groups were 20.4, 75.5, and 4.1 vs 14.6, 73.2 and 12.2 respectively (P = NS). Mean length of stay in the PACU for the two groups was 160 +/- 111 and 156 +/- 114 min (P = NS).

Our results show that in short procedures the use of desflurane does not necessarily result in faster patient recovery or discharge from the PACU.