Cañas BR, Izunza-Saldaña S, Moreno-Alatorre MA, Lozano-Noriega R

Language: Spanish
References: 17
Page: 203-207
PDF size: 55.34 Kb.

ABSTRACT

Objective: To compare the effects of desflurane and sevoflurane used for balanced general anesthesia regarding the ultra-fast-track extubation technique. Materials and methods: Thirty-five male and female patients, 20 to 60 years old, scheduled for elective heart surgery, were randomly assigned to one of two groups. Group A (n = 17) received desflurane and group B (n =18) received sevoflurane. Use of opioids, non depolarizing muscle relaxants, sedatives/hypnotics, and oxygen flow were standardized among both groups. Extubation conditions were evaluated at the end of surgery using the train-of-four ratio, respirometry and arterial gases. Results: The desflurane group showed a significant difference compared to the sevoflurane group, with a shorter time to extubation (17.25 minutes vs, 35.7 minutes, p ‹ 0.05). Conclusions: Both desflurane and sevoflurane appeared to be effective and safe anesthetic agents for the ultra-fast-track anesthesia technique in cardiac surgery. However, desflurane was better than sevoflurane in achieving extubation conditions faster.

REFERENCES

1. Chen ZM, White PF. The recovery of cognitive function after general anesthesia in elderly patients: a comparison of desflurane and sevoflurane. Anesth Analg 2001;93:1489-94.

2. Prakash O, Jhonson B, Meji S. Criteria for early extubation after intracardiac surgery in adults. Anesth Analg 1977;56:703-708.

3. González Ch, Luna P. Lineamientos para extubación temprana en cirugía cardíaca. Rev Mex Anest 1997;20:144-155.

4. Shroff A, Rooke GA, Bishop M J. Effects of intrathecal opioid on extubation time, analgesia and intensive care unit stay following coronary artery bypass grafting. J Clin Anesth 1997;9:415-419.

5. Meredeth AR. People with dementia who become lost: preventing injuries and death. Am J of Nursery 2003;103:32-39.

6. Warltier DC. A systematic review of the safety and effectiveness of fast track cardiac anesthesia. Anesthesiology 2003;99(4):983-987.

7. Cheng, Davy C. Randomized assessment of resource use in fast track cardiac surgery, 1 year after hospital discharge. Anesthesiology 2003;98(3):651-657.

8. Drumond GB. The assessment of postoperative mental function. Br J Anaesth. 1975; 47:130-142.

9. Hensley FA, Donald EM, Glenn PG. A practical approach to cardiac anesthesia, 3rd Edition 2003;1:160-251.

10. Heauner J. Recovery of elderly patients from two or more hours of desflurane or sevoflurane anaesthesia. Br J Anaesth 2003;91:502-506.

11. Fombeaur, Patricia O. Cost efectiveness of propofol anesthesia using target controlled compared with desflurane A J of Health Sistem. 2002;59:1344-1350.

12. De Hert, Stefan G. Effects propofol, Desflurane and Sevoflurane in recovery of myocardial function after coronary surgery in elderly high risk patients. Anesthesiology 2003;99:314-323

13. Kaplan JA. David LR, Steven NK. Cardiac Anesthesia, 4th Edition 1999: 540-565.

14. Hynninen MS, Cheng DCH, Hossain I, et al. Nonsteroidal anti inflammatory drugs in treatment of postoperative pain after cardiac surgery. Can J Anesth 2000;47:1182-1187.

15. Glass PSA. Pharmacokinetic and Pharmacodynamic principles in providing recovery. J Cardiothorac Vasc Anaesth 1995;9:16-20.

16. Schwilden H, Schuttler J, Stoekel H. Pharmacokinetics as applied to total intravenous anaesthesia: theorical considerations. Anaesthesia 1983;38:51-52.

17. Short TG, Plummer JL, Chui PT. Hypnotic and anesthetic interactions between midazolam, propofol and alfentanil. Br J Anaesth 1992;69:162-167.