Desflurane versus propofol maintenance for outpatient laparoscopic cholecystectomy |
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Authors: | J C RederPhD O Mjaland V Aasbø B Grøgaard T Buanes |
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Institution: | Department of Anaesthesia, Ullevaal University Hospital, Oslo, Norway;Department of Surgery, Day-Surgery Unit, Ullevaal University Hospital, Oslo, Norway |
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Abstract: | Background : The aims of the study were to evaluate costs and clinical characteristics of desflurane-based anaesthetic maintenance versus propofol for outpatient cholecystectomy. Methods : All 60 patients received ketamine 0.2 mg kg-1, fentanyl 2 μg kg-1 and propofol 2 mg kg-1 for induction. Ketorolac 0.4 mg kg-1 and ondansetron 0.05 mg kg-1 +droperidol 20 μg Kg-1 was given as prophylaxis for postoperative pain and emesis, respectively. The patients were randomly assigned into Group P with propofol maintenance and opioid supplements, or Group D with desflurane in a low-flow circuit system. Results : All the patients were successfully discharged within 8 h without any serious complications. Emergence from anaesthesia was more rapid after desflurane; they opened their eyes and stated date of birth at mean 6.4 and 8.4 min respectively, compared with 9.6 and 12 min in the propofol group (P<0.05). Nausea and pain were more frequent in Group D, 40% and 80% respectively; versus 17% and 50% in Group P (P<0.05). By telephone interview at 24 h and 7 d after the procedure, there was no major difference between the groups. With desflurane, drug costs per case were 10 $ lower than with propofol. Conclusion : We conclude that desflurane is cheaper and has a more rapid emergence than propofol for outpatient cholecystectomy. However, propofol results in less pain and nausea in the recovery unit. Despite ondansetron and droperidol prophylaxis, there was still a substantial amount of nausea and vomiting after desflurane. |
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Keywords: | Ambulatory surgery anesthesia general cholecystectomy laparoscopic desflurane fatigue postoperative health economy nausea postoperative pain postoperative propofol |
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