A Comparison of Emergence Behaviour and Cost Effectiveness in Tonsillectomy Patients Undergoing General Anaesthesia with Desflurane versus Sevoflurane

Nirmalyo Lodh; Vandana Parmar; Vrinda Oza; Feny Thakkar

doi:10.18502/aacc.v8i3.9617

Nirmalyo Lodh Departmen of Critical Care,Guy’s & St Thomas NHS Foundation Trust, London, United Kingdom.
Vandana Parmar Departmen of Anaesthesiology, P.D.U.Medical college & Hospital, Saurashtra University, Rajkot, India.
Vrinda Oza Departmen of Anaesthesiology, P.D.U.Medical college & Hospital, Saurashtra University, Rajkot, India.
Feny Thakkar Departmen of Anaesthesiology, Saurashtra Cancer Care and Research Institute, G.C.R.I., Ahmedabad, India.

DOI: https://doi.org/10.18502/aacc.v8i3.9617

Keywords: Volatile anaesthetics; Recovery and emergence profile; Sevoflurane; Desflurane

Abstract

Background: It has been seen that volatile anaesthetics agents which are speedily eliminated with minimal breakdown should facilitate faster recovery from general anaesthesia. As compared to isoflurane-based anaesthesia, both sevoflurane and desflurane have shorter emergence times due to rapid induction and elimination.

Aim: The aim of this study is to compare and analyse the superiority of both agents, with regards to the emergence and recovery from anaesthesia, intraoperative hemodynamics, postoperative side effects and estimate the average quantity and cost-benefit of both volatile agents consumed.

Methods: Total of 100 cases above the age of 6 years undergoing tonsillectomy surgeries of ASA grade 1& 2 was included. Patients were allocated into two groups by computer-generated numbers. Group S: Anaesthesia maintained with 50/50 mixture of nitrous oxide/oxygen and sevoflurane. Group D: Anaesthesia maintained with 50/50 mixture of nitrous oxide/oxygen and desflurane. The parameters recorded were compared between the two groups using the unpaired t-test for continuous variables and P≤0.005 is deemed significant.

Results: There was no significant hemodynamic difference intraoperatively between sevoflurane and desflurane except in the desflurane group, heart rate was higher. Recovery was faster and better in Group D.

Conclusion: Postoperative recovery was better and faster and postoperative complication was lower in the desflurane group. Though the total cost of desflurane group was higher compared to sevoflurane but the use of desflurane can be justified with lesser complication, faster emergence from anaesthesia, faster shifting from PACU, lesser hospital stays, lower chance of nosocomial infection and lower cost of hospital stay.