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Length of postanesthetic care unit stay in elderly patients after general anesthesia: a randomized controlled trial comparing desflurane and sevoflurane

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J Clin Anesth, 2015 Sep 28.

Authors: Pakpirom J et al

OBJECTIVE:

The purpose of this study was to compare the length of postanesthetic care unit (PACU) stay and recovery profiles of elderly patients after general anesthesia between sevoflurane and desflurane.

DESIGN:

Randomized, double-blind, controlled clinical trial.

SETTING:

Tertiary care hospital, university hospital.

PATIENTS:

Eighty elderly patients undergoing nonemergency surgery under general anesthesia.

INTERVENTION:

Patients were randomly allocated into 2 groups: sevoflurane group (n = 38) and desflurane group (n = 42) in a double-blind manner. All of the patients underwent general anesthesia with oral endotracheal intubation using the same induction, muscle relaxants, and narcotics medication. When the operation was finished, the volatile agent was discontinued and muscle relaxation was reversed.

MEASUREMENT:

The length of PACU stay was recorded as the primary outcome. The recovery profiles (time to open eyes, time to follow to commands, and time to extubation) were assessed.

MAIN RESULTS:

There was no significance between the groups in age, sex, body mass index, American Society of Anesthesiologists physical status, type of surgery, duration of anesthesia, perioperative use of fentanyl, or blood loss. The length of PACU stay was not significantly different in the patients who recovered from sevoflurane (49.4 ± 23.1 minutes) or desflurane (50.1 ± 25.8 minutes) general anesthesia. Desflurane was significantly associated with faster early recovery than sevoflurane measured by time to open eyes (7.5 ± 3.4 vs 9.6 ± 4.6 minutes) and time to follow commands (9.0 ± 3.3 vs 11.2 ± 5.1 minutes), respectively.

CONCLUSION:

Desflurane was more associated with a faster early recovery (time to open the eyes and follow commands) than sevoflurane in elderly patients after general anesthesia. However, the length of PACU stay was similar in both groups.

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