Desflurane versus sevoflurane in laparoscopic cholecystectomy: A comparison of recovery profile and home discharge in Indian patients

Abstract

Context: Laparoscopic cholecystectomy is one of the most commonly performed minimal access surgeries nationwide, safely done as a day care procedure. Anesthetic techniques facilitating early recovery and home discharge have become the need of the hour. Aims: To compare early, intermediate, late recovery characteristics and time to home readiness following use of sevoflurane or desflurane as maintenance anesthesia in laparoscopic cholecystectomy in Indian subpopulation. In addition, postoperative complications such as coughing and shivering and total antiemetic and analgesic requirements postoperatively were also noted. Settings and Design: This was a prospective randomized study, and randomization was done by computerized random number table into two groups (30 patients in each group). Group S received sevoflurane and Group D received desflurane as maintenance agent. Subjects and Methods: Sixty patients of age group 18–60 years belonging to the American Society of Anesthesiologists Grade I and II undergoing laparoscopic cholecystectomy were recruited. A standard anesthesia induction was done and airway was secured with a ProSeal laryngeal mask airway of appropriate size. The patients subsequently received either sevoflurane 1%–2% or desflurane 3%–6% with 60% N2 O in O2 as per group assigned. Inhalational agent was discontinued at the time of endoscope removal. Early, intermediate, and late recovery parameters were noted. Statistical Analysis: The tests of significance used were parametric test (unpaired t-test) and ANOVA. The outcome measures were compared statistically using unpaired t-test and ANOVA, and P < 0.05 was considered statistically significant. Results: Early recovery parameters were achieved faster in patients receiving desflurane as compared to sevoflurane with no difference in time to achieve intermediate recovery and home readiness. Conclusion: Despite a faster early recovery with desflurane, no additional benefit in terms of home discharge and patient satisfaction was found, thus making use of either of the agents suitable for laparoscopic cholecystectomy on a day care basis.

Keywords

• cholecystectomy
• day care
• desflurane
• laparoscopic
• postoperative recovery
• sevoflurane