Key result
Desflurane speeds post-operative recovery over sevoflurane with comparable intraoperative haemodynamics in elective thyroid surgery.
Why the study?
Maintaining stable intraoperative haemodynamics and ensuring early, smooth postoperative recovery are challenges in thyroid surgeries under general anaesthesia, with unclear comparative data on sevoflurane versus desflurane.
Does desflurane improve intraoperative haemodynamics and postoperative recovery compared to sevoflurane in patients undergoing elective thyroid surgery?
RCT (n=70)
randomly assigned
No
Does desflurane improve intraoperative haemodynamics and postoperative recovery compared to sevoflurane in patients undergoing elective thyroid surgery?
p-value: p=>0.05
Desflurane provides comparable intraoperative haemodynamics but quicker post-operative recovery compared to sevoflurane in patients undergoing elective thyroid surgery.
May support low-solubility volatiles for thyroid surgery anesthesia; leaves open need for RCTs to confirm recovery and stability.
BACKGROUND Maintaining deep plane of anaesthesia to prevent haemodynamic fluctuation and absolute immobility at the same time ensuring early and smooth recovery to prevent bleeding and assessing vocal cord status are the challenges to the anaesthesiologists in thyroid surgeries. Use of volatile anaesthetics with low solubility and low blood gas partition coefficient are used for their haemodynamic stability and faster emergence from anaesthesia in various surgeries under general anaesthesia. we wanted to compare sevoflurane and desflurane in terms of intraoperative haemodynamics, postoperative emergence and recovery characteristics in thyroid surgeries of less than 2 hours duration. METHODS After getting institutional ethical committee approval, 70 patients belonging to American Society of Anaesthesiologists (ASA), physical status I or II undergoing elective thyroid surgery were randomly assigned to two groups to receive either 6 % Desflurane (group D ) or 2 % Sevoflurane (group S) for maintenance of general anaesthesia along with 33 % oxygen with 67 % nitrous oxide. The intraoperative heart rate, mean arterial pressure were recorded at 5 minute intervals and recovery characteristics including times to extubation, first spontaneous motion, response to painful pinch, recall of name, hand grip and PARS score ≥ 9 were recorded in both groups. RESULTS There was no statistically significant difference (P > 0.05) in mean heart rate and mean arterial pressure between group D and S and remained within 20 % of baseline. The time to achieve a PARS ≥ 9 was earlier in the desflurane group and it was statistically significant. CONCLUSIONS Desflurane and Sevoflurane based anaesthesia provides comparable intraoperative haemodynamics whereas post-operative recovery was quicker in patients who received Desflurane compared to Sevoflurane. KEYWORDS Desflurane, Haemodynamics, Recovery, Sevoflurane
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Siddique et al. (2021) conducted an RCT in Elective thyroid surgery (n=70). Desflurane vs. 2% Sevoflurane was evaluated on Intraoperative haemodynamics (mean heart rate and mean arterial pressure) and recovery characteristics (p=>0.05). Desflurane provided comparable intraoperative haemodynamics to Sevoflurane (P>0.05) but resulted in significantly quicker post-operative recovery in patients undergoing elective thyroid surgery.
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