Anaesthesia during laparoscopic gynaecological surgery: A comparison between desflurane and isoflurane

Desflurane is a new inhalation anaesthetic with a low blood/gas solubility which should allow a fast emergence from anaesthesia. In a prospective open randomized study, desflurane was compared with isoflurane paying special attention to recovery and the quality of the post-operative period. The occurrence of pain and post-operative nausea and vomiting (PONV) was recorded during the first 20 post-operative hours. Seventy women ASA Grade I-II scheduled for elective gynaecological laparoscopic procedures were studied. Patients receiving desflurane were extubated earlier than patients receiving isoflurane, 5 +/- 1 and 9 +/- 1 min respectively (P<0.05) and the patients anaesthetized with desflurane were able to tell their name and date on average 5 min earlier than those who had received isoflurane; however, time in the recovery room was the same for both groups of patients. Twenty-two of 35 patients receiving desflurane, and 18 of 35 receiving isoflurane required analgesia. PONV was recorded in 18 patients anaesthetized with desflurane and 12 patients anaesthetized with isoflurane. In both groups PONV was more frequently observed in patients after leaving the recovery room. PONV in the recovery room was associated with a delayed discharge, 139 vs. 114 min respectively. Desflurane seems to be an useful alternative to isoflurane for laparoscopic procedures.