Comparison of recovery and side effects after optimal isoflurane/sevoflurane/desflurane anaesthesia with BIS monitoring in patients undergoing laparoscopic abdominal surgery

Aims: Rapid recovery of the patient after the surgery is important for the patient to gain consciousness quickly and full wakefulness is important for both anesthesiologist and for the patient. This becomes more important especially in daily surgeries such as laparoscopic surgery procedures. Rapid recovery of consciousness after extubating, spontaneous respiratory sufficiency, adequacy of protective airway reflexes minimizes respiratory side effects during recovery period. In patients under general anesthesia, EEG activity reverts from low-voltage fast waveform to high-voltage slow waveform. BIS anesthesia, as an EEG variant, is a simple and easy-to-use Monitor that measures the depth of anesthesia. With this monitor, it is easier to measure the depth of anesthesia and evaluate the recovery. In our study, we aimed to evaluate the difference between recovery times and side effect rates after Isoflurane/sevoflurane/Desflurane anesthesia. Methods: 105 patients in ASA I-II risk group between 18-60 years of age whose elective laparoscopic cholecystectomy was planned in our hospital were included in our research. All patients were induced with 2 µg/kg of fentanyl, 2.5 mg/kg of propofol, 0.6 mg/kg of rocuronium for general anesthesia. After intubation, 0.5-1.5% Isoflurane was given to group I, 1-4% sevoflurane to Group II, and 2-6% Desflurane to Group III patients as inhaler agents. Results: In patient groups for which demographic data do not have any statistically significant difference, monitoring with BIS reduces the amount of anesthetic used in three groups and prevents intraoperative awareness. When compared between groups Desflurane was the fastest recovered group with fastest rising BIS score due to the low blood/gas partition levels. However, contrary to our expectations, sevoflurane was not very different from Isoflurane. In addition, contrary to expected, the incidence of nausea after extubating was higher in this group. But at the end of the 1st hour, emetic symptoms were significantly higher in the sevoflurane group. Conclusion: BIS use reduces the amount of inhaler agent use in anesthesia depth measurement. In patients with optimal anesthesia depth, postoperative recovery is fast and side effects such as nausea and vomiting reduce. In our study, we determined that Desflurane, which is an agent with low blood/gas partition coefficient, was the fastest to be recovered compared to other groups.