Early recovery properties of sevoflurane and desflurane in patients undergoing total hip replacement surgery

Background. The pharmacokinetic properties of sevoflurane and desflurane differ from those of other volatile anesthetics. For example, both agents allow more rapid emergence than traditional volatile anesthetics. However, few direct comparisons of the 2 agents have been made. Objective: The aim of this study was to compare the early recovery properties of desflurane and sevoflurane in patients with American Society of Anesthesiologists physical status I or II undergoing total hip replacement (THR) surgery. Methods: This open-label study was performed at the Department of Anesthesiology, Erciyes University School of Medicine, Kayseri, Turkey. Early recovery was assessed in the surgical suite by measuring the time to 50% decline of end-tidal volatile concentration of desflurane or sevoflurane; time to extubation, eye opening, orientation, and a modified Aldrete Scale (MAS) score >8 (ie, safe to discharge from the surgical suite); and time to discharge from the postanesthesia. recovery room. Results: Time to 50% decline of end-tidal volatile concentration of desflurane or sevoflurane, tracheal extubation, eye opening, orientation, and an MAS score >8 occurred significantly more rapidly in the desflurane group than in the sevoflurane group (P < 0.001). However, the groups did not differ significantly in duration of anesthesia; time to discharge from the postanesthesia recovery room; or incidences of nausea, vomiting, dizziness, and drowsiness in the first 24 hours after anesthesia. Conclusions: In this study population, desflurane provided significantly more rapid early recovery than sevoflurane, but we did not find any beneficial effects of desflurane on intermediate recovery. The rapid emergence from anesthesia may facilitate more efficient surgical suite use and may be associated with more benefits after prolonged anesthesia. We suggest that both volatile agents may be acceptable anesthetics for use during THR surgery.