Comparative study of recovery of airway reflexes and cognitive function following sevoflurane versus desflurane anaesthesia.

BACKGROUND AND AIMS: Sevoflurane and desflurane have almost similar blood-gas solubility but recent studies suggest that desflurane compared to sevoflurane leads to faster recovery of airway reflexes, but the recovery of cognitive function varies significantly. We conducted this study to compare the times of recovery from anaesthesia following desflurane versus sevoflurane anaesthesia.

METHODS: This randomised double-blinded study was conducted on 60 patients of American Society of Anesthesiologists (ASA) classification I-II, age between 18 and 60 years with body mass index (BMI) ≤30 kg/m2 who underwent elective cholecystectomy. A standard general anaesthesia protocol was followed with either sevoflurane (group A = 30 patients) or desflurane (group B = 30 patients) along with bispectral index and neuromuscular monitoring. Following extubation, tests for recovery of airway reflexes and cognitive function were conducted and various time intervals were noted. Statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) standard software version 17.

RESULTS: The mean time from first verbal response to first passing the swallowing test was comparable in both the groups (5.50 ± 3.45 vs. 4.10 ± 3.42 min, P value = 0.120). Patients receiving desflurane showed faster response to verbal commands (5.93 ± 4.13 vs. 8.20 ± 3.39 min, P value = 0.024), passed the swallowing test earlier (10.03 ± 4.97 vs. 13.70 ± 3.48 min, P value = 0.009) and Short orientation memory concentration test (SOMCT) earlier (9.83 ± 4.51 vs. 14.10 ± 4.31 min, P value ≤0.001) compared to sevoflurane.

CONCLUSION: In patients undergoing laparoscopic cholecystectomy under controlled conditions, earlier recovery is seen with desflurane compared to sevoflurane.