Safety and Consumption of Sevoflurane Versus Desflurane Using Target Controlled Anesthesia in Children

Background: Recently a concept of target controlled inhalational anesthesia (TCA) is introduced in which the fresh gas flow and its composition are automatically delivered to the patients with the least possible flow. The aim of this study was to compare safety, consumption and cost of both sevoflurane and desflurane when delivered by TCA using closed circuit anesthesia. Patient and Method: Sixty pediatric patients aged 2-12 years and ASA status I-II with normal liver and kidney function scheduled for procedures longer than two hours. The patients were classified into two groups according to the anesthetic delivered by auto control mode: S Group (n=30) in which sevoflurane was delivered D Group (n=30): In which desflurane was delivered. Anesthetic agent and O 2 consumption, cost and number of adjustments were assessed. Blood samples were obtained preoperatively and at 24, 48 and 72h postoperatively for measuring serum creatinine, BUN, AST and ALT. Twenty-four hour urine samples were collected for 3 consecutive days to measure glucose, microprotein and Creatinine for estimation of creatinine clearance. Results: Sevoflurane group had a lower O 2 , anesthetic consumption and cost than desflurane group. Also both groups had higher levels of serum urea and creatinine together with urinary microproteins and glucose in the first three postoperative days compared to preoperative values. However there was no statistically significant difference between the two groups. All values were within normal values in both groups by the 3 rd day. Conclusion: Sevoflurane is as safe as desflurane when delivered by auto control mode of Zeus machine with decreased anesthetic consumption and cost.