Comparison of morbidity of outpatient general anesthesia administered by the intravenous or inhalation route

Purpose: This study compares the morbidity between subjects receiving general anesthesia either by an intravenous or inhalation route for the extraction of impacted third molars in an outpatient setting. Patients and Materials: Forty ASA Class I subjects, 21 females and 19 males (age range, 17 to 43 years), who presented for the extraction of four impacted third molars, were studied. Subjects were alternately assigned to receive general anesthesia either by the intravenous route (group I) or the inhalation route via an endotracheal tube (group IT). The parameters for comparison included psychomotor recovery, cardiovascular changes 20% above or below baseline, the frequency of nausea and vomiting perioperatively and at 48 hours, occurrence of laryngospasm and bronchospasm, the frequency of sore throat both perioperatively and at 48 hours, procedure time, and recovery time. The Trieger dot test was administered to patients at three different intervals to evaluate psychomotor recovery. All parameters were recorded for each subject and compared both within and between groups. Results: There was no statistical difference found between groups I and II with regard to psychomotor recovery, the frequency of nausea and vomiting, bronchospasm, laryngospasm, or median recovery time (P < .05). However, there was greater variability in both elevation and depression of blood pressure from baseline in the intubated subjects (P < .05). These deviations were both expected and easily managed. The probability of sore throat was greater in the intubated subjects (P < .05) than the nonintubated subjects. Procedure time, although a weak association, was nonetheless found to be significantly greater for the intubated group than for the intravenous group (P < .05). Summary: The results show greater cardiovascular variability, increased probability of sore throat, and slightly lengthened procedure time with the administration of general anesthesia by an inhalational route via an endotracheal intubation. However, there was no difference with regard to psychomotor recovery, recovery time, the probability of nausea and vomiting, or incidence of laryngospasm or bronchospasm.