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Desflurane versus propofol anesthesia: a comparative analysis in outpatients
M H Lebenbom-Mansour1, S K Pandit, S P Kothary
1University of Michigan School of Medicine, Department of Anesthesiology, Ann Arbor.
Anesthesia and Analgesia
|May 1, 1993
Summary
Desflurane offers rapid awakening and intermediate recovery for ambulatory surgery, though induction quality was lower than propofol. It proved a suitable maintenance anesthetic with similar hemodynamics and reduced vomiting compared to propofol.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- General anesthesia involves balancing induction, maintenance, and recovery.
- Desflurane and propofol are common anesthetic agents with distinct properties.
Purpose of the Study:
- To compare desflurane and propofol for general anesthesia in outpatient orthopedic surgery.
- To evaluate induction, hemodynamic, and recovery characteristics.
Main Methods:
- Sixty outpatients were randomized into four groups based on anesthetic induction and maintenance agents (propofol or desflurane).
- Data collected included induction quality, emergence time, intermediate recovery, psychomotor function, and postoperative outcomes (narcotic use, vomiting).
Main Results:
- Desflurane induction (Groups 3 & 4) showed poorer quality (more breath-holding, excitation) than propofol induction (Groups 1 & 2).
- Group 4 (desflurane maintenance) demonstrated significantly faster emergence (ability to state name).
- Intermediate recovery and psychomotor function were similar between propofol infusion (Group 2) and desflurane maintenance (Group 4).
- Hemodynamic profiles were comparable across all groups.
- Group 3 (desflurane induction/maintenance) had higher vomiting rates (50%) than Group 2 (0%) and Group 4 (12.5%).
Conclusions:
- Desflurane is challenging for anesthetic induction but suitable for maintenance in ambulatory surgery.
- Desflurane provides rapid awakening and intermediate recovery comparable to propofol.
- Propofol infusion may be preferred over desflurane induction to mitigate vomiting.