Emergence and Recovery Characteristics of Desflurane versus Sevoflurane in Morbidly Obese Adult Patients Undergoing Abdominal Surgery

Background: Early and complete recovery after general anesthesia is desirable in all patients, more so in the morbidly obese patients. All volatile anesthetics accumulate, over time, in adipose tissue. Such accumulation may delay recovery from anesthesia. The new fluorinated agents have markedly improved the quality and the time required for recovery compared with the older inhaled anesthetics. Aim: This study was done to compare the maintenance and recovery characteristics of Sevoflurane versus Desflurane in morbidly obese patient, Method: Fifty morbidly obese patients (BMI > 35kg/ meter square) requiring Abdominal surgery were randomly allocated to 2 groups (25 patients in each group)Group A received 1 MAC target concentration of Desflurane and GROUP B received 1MAC target concentration of Sevoflurane in oxygen for maintenance. EtCO2 (end-tidal carbon dioxide) was maintained between 30-40mm Hg. The MAP and HR were targeted to maintain within ± 20% of the baseline values throughout intra operative period. Results: Early recovery parameters were achieved statistically significantly(p<0.05) faster in Desflurane group in comparison to Sevoflurane group. Time for response to eye opening was earlier by 1.41 minutes, time for hand grip was faster by 1.61 minutes, time for tracheal extubation was significantly faster by 2.21 minutes in Desflurane group than Sevoflurane group. Time to state his/her own name and name of village were also significantly faster in Desflurane group by 2.76 minutes and 2.76 minutes respectively. Intermediate recovery (the time to discharge the patient from the PACU) was comparable between two groups. (p>0.05). Conclusion: In morbidly obese patients, using 1 MAC end-tidal concentration, we found that the time to emergence and early recovery from prolonged anaesthesia with Desflurane is shorter than with Sevoflurane anaesthesia