Online ISSN: 2515-8260

Keywords : sevoflurane

Comparison Of The Airway Response And Recovery Profile Of Desflurane For Ambulatory Anaesthesia With Those Of Sevoflurane

Dr.Reshma Immanuel, Prof.Dr.U.G.Thirumaaran

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2906-2914

Background and Aims: Low blood gas solubility coefficients of desflurane and sevoflurane enable a quick recovery from anaesthesia. Desflurane, meanwhile, has a strong smell and might irritate the airways. While employing the ProSealTM laryngeal mask airway, we examined the effects of desflurane and sevoflurane on recuperation and the occurrence of adverse airway reactions in patients who were breathing on their own (LMA). Methods: In 94 adult patients who received hysteroscopic operations, sevoflurane (S) or desflurane (D) groups were created. Fentanyl 1 g/kg and midazolam 0.03 mg/kg were used as premedicators on the subjects. Adverse airway reactions, such as coughing, hiccups, laryngospasm, and breath holding, were observed after propofol 2.0-2.5 mg/kg was used to induce anaesthesia and a ProSealTM LMA was inserted. Time to awakening, verbal command response, orientation, the capacity to sit with support, and the Aldrete score for the recovery area were all noted during the post-operative interval. Results: Three patients in group S (6.4%) and six patients (13.3%) in Group D had adverse airway events. The mean time to eye opening (Group S-10.75 ± 7.54 min, Group D-4.94 ± 1.74 min), obeying verbal commands (Group S-13.13 ± 8.75 min, Group D-6.55 ± 1.75 min), orientation (Group S-15.42 ± 8.46 min, Group D-6.23 ± 2.4 min) and to sit with support (Group S-36.09 ± 12.68 min, Group D-14.35 ± 3.75 min) were found to be lesser with desflurane than with sevoflurane (P < 0.001). The mean time to recovery was delayed in Group S-46.00 ± 12.86 min compared to Group D-26.44 ± 5.33 min (P < 0.001). Conclusion: Desflurane, when combined with propofol and fentanyl while spontaneous breathing with a ProSealTM LMA, exhibits faster awakening qualities than sevoflurane without a rise in adverse airway outcomes.

To compare the intraoperative haemodynamic parameters and cost effectiveness between sevoflurane (inhalational) anaesthesia and propofol (tiva) based anaesthesia

Dr Ravneet Singh Bhusari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 445-450

Aim: To compare the intraoperative haemodynamic parameters and cost effectiveness between sevoflurane   (inhalational)   anaesthesia   and propofol (tiva) based anaesthesia
Methods: Following informed consent, hundred ASA I and II patients aged 19-63 years of either sex having general anaesthesia were randomly split into two groups of 50. Patients with an ASA of III or higher, major cardiovascular, renal, or pulmonary disease, a history of malignant hyperthermia, any documented allergy to the study agent, H/O any mental condition, or use of sedative medicines were excluded from the study. Sevoflurane was used in Group A, while Propofol was used in Group B.
Results: The Sevoflurane group (51.02±4.52) had a quicker induction time (sec) than the Propofol group (61.29±5.51), which was statistically significant (p<0.001). The recovery profile after the agents were withdrawn at the conclusion of surgery revealed a significant difference in spontaneous eye opening (9.5±1.3 min in Sevoflurane group and 13.4±1.4 min in Propofol group), verbal communication (11.5±1.9 min in Sevoflurane group and 14.6±1.9 min in Propofol group) and mental orientation (16.1±1.6 min Sevoflurane group and 20.3±2.1min Propofol group) (p<0.001), with Sevoflurane demonstrating the superior recovery profile.
Conclusion: In terms of quicker induction and rapid recovery characteristics, we discovered that Sevoflurane outperforms Propofol. The intraoperative hemodynamics of the two groups were equivalent, with no statistically significant difference. However, Sevoflurane-based anaesthesia is still more expensive than Propofol, which if addressed would serve as a good choice of anaesthesia in impoverished nations.

Effect of induction with propofol-fentanyl and sevoflurane-fentanyl on postoperative nausea and vomiting after laparoscopic surgery: A comparative study

Varaprasada Rao T, Sirisha T

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1201-1206

Introduction: Post-operative nausea and vomiting is one of the very common complications after a surgery. Prevention of PONV in patients results in improved patient satisfaction and cost effective patient care.
Materials and methods: 50 patients were randomly divided into 2 groups, Group A were the patients who received Propofol- Fentanyl and group B, who received Sevoflurane – Fentanyl. Before surgery, the baseline conditions, such as the baseline pulse rate, blood pressure, SpO2 were taken. Injection glycopyrolate 0.2 mg/kg was given intramuscularly half hour prior to the surgery. 100% oxygenation was given to all the patients for 3 minutes. During Preinduction, all the patients were given 1-1.5 mcg/kg IV Fentanyl.
Results: In the Group A most of the patients had no nausea post-surgery, while 5 of them had mild nausea. However. Out of the patients in Group B, 32% each had mild or no symptoms, but 7 (28%) PONV Grade III, which was significantly higher. In group A, 48% of the patients who were either overweight or obese had no nausea, while 16% of them had mild nausea, 12% had Grade III PONV. Of the patients with normal BMI in Group A, only 1 (4%) had mild nausea, while all the others had no symptoms. In group B, 7 (28%) of the overweight and obese Patients had grade III nausea i.e. 1-2 Vomiting’s in 12 hours with nausea, while 2 (8%) had >3 vomiting in 12 hours with nausea. 6 (24%) each had mild nausea or no nausea.
Conclusion: Although the efficacy of both sevoflurane and Propofol is similar, Propofol is the more preferred drug due to the lesser amounts of cases of nausea and vomiting, thereby resulting in higher patient satisfaction.