Desflurane versus sevoflurane for laparoscopic gastroplasty in morbidly obese patients.

STUDY OBJECTIVE To determine if desflurane results in a faster emergence as measured by time to eye opening compared to sevoflurane in morbidly obese patients undergoing laparoscopic gastroplasty. STUDY DESIGN Prospective, randomized, double-blinded study. SETTING Tertiary care hospital. PATIENTS 70 patients with a body mass index of 35 or higher undergoing laparoscopic gastroplasty. INTERVENTIONS Patients were randomized into two groups to receive either desflurane or sevoflurane for maintenance of general anesthesia. MEASUREMENTS Intraoperative measured variables included the time from when the inhalation agent was turned off (no agent delivered) to eye opening and the time from when the inhalation agent was turned off to extubation. Postanesthesia care unit (PACU)-measured variables on admission and at 15 minute intervals until discharge included oxygen saturation (Spo2), blood pressure, heart rate, pain and nausea Visual Analog Scale (VAS) scores, emesis, modified Aldrete score, and Mini-Mental Status (MMS) examination score. MAIN RESULTS No differences were noted in demographic data, total surgical operative time, times from turning inhalation agent off to eye opening and extubation, or average length of stay in PACU. No differences were noted with respect to pain VAS, treatment for pain, modified Aldrete scores, emesis, or treatment for postoperative nausea or emesis. Differences were noted in PACU nausea VAS at 15 minutes, PACU nausea VAS at discharge, and PACU-MMS score at 45 minutes; however, multivariate analysis of variance revealed no differences between groups over the repeated PACU measured time periods in nausea VAS (P=0.17) or in MMS (P=0.34). Higher heart rates in the desflurane group were observed during PACU admission (82.3+/-9.8 vs 74.4+/-13.4 bpm, P<0.01) and 15 minutes post PACU admission (79.4+/-12.1 vs 71.3+/-13.2 bpm, P=0.01). CONCLUSIONS In morbidly obese patients undergoing laparoscopic gastroplasty, emergence, as measured by time to eye opening, did not differ between desflurane and sevoflurane, with similar recovery characteristics.