Thursday, October 25, 2012

The recovery profiles after anaesthesia with desflurane or sevoflurane combined with TCI Propofol and TCI Remifentanil in morbidly obese patients.

The recovery profiles after anaesthesia with desflurane or sevoflurane combined with TCI Propofol and TCI Remifentanil in morbidly obese patients.

Alisher Agzamov, A. M. Al Qattan, Mohammad Al Khashti, Mohammad Behzad.

The Department of Anaesthesiology & ICU, Al Sabah & Zain Hospitals, Kuwait City, KUWAIT..

This randomized prospective study with blinded postanaesthesia care unit (PACU) observers compared the recovery profiles in morbidly obese patients who received sevoflurane or desflurane for maintenance of anaesthesia in combination with a Remifentanil target controlled infusion (TCI).

420 morbidly obese patients (BMI > 40 - 75) scheduled for laparoscopic gastric banding were included to receive AEP and BIS-guided sevoflurane or desflurane anaesthesia with AEP & BIS-triggered inhalation in combination with TCI Propofol & TCI Remifentanil. In the PACU, the following recovery scores were investigated: Modified Aldrete score, a modified Observers Assessment of Alertness/Sedation Scale (OAA/S), pain numerical rating scale (NRS), oxygen saturation (SpO(2)) and postoperative nausea and vomiting (PONV).

OAA/S and NRS pain scores showed a similar evolution in both groups from the moment of PACU admission up to 30 minutes after admission. In both groups, patients showed no serious hypoxemia during PACU stay. Incidence of PONV was shorter lasting in the sevoflurane group compared to the desflurane group.

No clinically relevant difference was found in recovery in the PACU between morbidly obese patients anesthetized with desflurane or sevoflurane. Both anesthetics gases: sevoflurane and desflurane resulted in satisfactory recovery in morbidly obese patie

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