Recovery after desflurane anaesthesia in the infant: comparison with isoflurane

We have studied 20 infants, aged 2.5-8 weeks, undergoing general anaesthesia for pyloromyotomy with either desflurane or isoflurane. Patients were anaesthetized with equivalent 1 MAC values for age and agent. A blinded observer recorded times to breathing, swallowing, movement, extubation and side effects after discontinuation of the agent. Recovery times in the desflurane group were significantly shorter than in the isoflurane group. The times to swallowing, movement and extubation in the desflurane group were 3.89 (SD 2.4) min, 5.33 (4.95) min, 7.5 (4.53) min, respectively, and 8.82 (2.40) min, 10.73 (3.93) min, 13.45 (4.20) in the isoflurane group. In addition, postoperative apnoea was documented in the isoflurane group but not in those infants receiving desflurane. There was no laryngospasm after extubation in either group. We conclude that desflurane possesses useful characteristics for recovery conditions in the infant and may be particularly useful in the ex-premature infant prone to apnoea and ventilatory depression.