An Observational Study to Compare Recovery of Elderly Patients from General Anaesthesia with Sevoflurane or Desflurane
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 4
Abstract
Background: The clinical study was undertaken to compare the recovery of elderly patients from general anaesthesia with sevoflurane or desflurane with reference to spontaneous eye opening, obeying verbal commands, recall of name, squeezing fingers, time to extubation and orientation and Modified Aldrette Score. Material and Method: Study was conducted on 60 patients of either sex, belonging to ASA I, II and III posted for elective surgeries. Age of the patients were above 60 years and were divided into groups of 30 each (group D and group S).All patients were pre medicated with inj. glycopyrrolate 0.004 mg/kg i.v, inj. fentanyl 1microgram/kg i.v., inj ondansetron 0.1 mg/kg i.v., inj.ranitidine 50mg i.v. After preoxygenation with 100% for 5 minutes, patients were induced with injection propofol 1-2 mg/kg i.v. and intubation facilitated with injection succinyl choline 1.5mg/kg i.v. Anaesthesia was maintained with either desflurane (group D) or sevoflurane (group S) in combination with N2O 50% in O2 50% . All patients were mechanically ventilated. Both group received Fresh gas Flow of 4 lit/min for first 10 mins. After 10 mins FGF was reduced to 2 lit/min. with desflurane and sevoflurane adjusted so as to maintain hemodynamic parameter within 20% of baseline values or according to clinical parameters. Muscle relaxation was maintained by using injection atracurium i.v (loading dose) and top up doses were guided by PNS. Desflurane/Sevoflurane and N2O were turned off after the last skin suture. Neuromuscular blockade was reversed by inj. neostigmine 0.05 mg/kg and inj. glycopyrrolate 0.008 mg/kg and patients were extubated . Time to extubation was recorded as time from discontinuation of inhalation to extubation. Pulse rate (P.R), systolic blood pressure (SBP), Diastolic blood pressure (D.B.P), oxygen saturation (SpO2), electrocardiography (ECG) were observed throughout the surgery at every 10 mins. Recovery was assessed in the PACU by using the Modified Alderete Score every 5 minutes for intial 10 minutes and then every 10 minutes till 60 minutes. Result: The recovery parameters of spontaneous eye opening, obeying verbal commands, recall of name, squeezing of fingers, time to extubation and place of stay were significantly shorter in patients of Desflurane group as compared to patients of Sevoflurane group (p<0.05). Patients given desflurane achieved Modified Aldrete Score of 9 significantly faster than patients given sevoflurane. Conclusion: We concluded that although sevoflurane and desflurane provided similar intra-operative conditions, desflurane provided more rapid recovery and the return of cognitive functions in the early post operative period.
Authors and Affiliations
Suman Shekhar Tiwari
Keywords
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- EP ID EP539023
- DOI 10.21088/ijaa.2349.8471.5418.19
- Views 92
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