Desflurane versus isoflurane in geriatric patients. A comparison of psychomotor and postoperative well-being following abdominal surgical procedures

Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
J MotschE Martin

Abstract

The new volatile anaesthetic agent desflurane has a significantly lower blood-gas partition coefficient (0.42) than isoflurane (1.4), suggesting excellent intraoperative control of anaesthesia and rapid emergence and recovery from anaesthesia. However, only limited experience is available in geriatric patients undergoing major abdominal surgery. After approval by the local ethics committee and with written informed consent, 52 patients (> or = 65 years old, ASA class II or III) scheduled for major abdominal surgery were randomised to receive either desflurane (DES) or isoflurane (ISO) for maintenance of anaesthesia. After oral premedication with midazolam 3.75-7.5 mg, anaesthesia was induced with etomidate 0.2-0.3 mg/kg and fentanyl 3 micrograms/kg. Vecuronium 0.1 mg/kg provided muscle relaxation for endotracheal intubation. All patients were mechanically ventilated to maintain normocapnia. For maintenance of anaesthesia, DES or ISO was administered in 60% N2O and additional boluses of fentanyl and vecuronium were given as required. At the end of surgery, the neuromuscular blockade was reversed with neostigmine 0.02 mg/kg and DES or ISO was discontinued at the end of skin closure. Episodes of bradycardia and tachycardia and hyp...Continue Reading

Citations

Oct 26, 2016·British Journal of Clinical Pharmacology·Lenneke SchrierGeert Jan Groeneveld

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