Bispectral index-guided desflurane and propofol anesthesia in ambulatory arthroscopy: comparison of recovery and discharge profiles

Abstract

In this prospective, randomized study we compared the recovery profiles of bispectral index (BIS)-guided anesthesia regimens with desflurane or propofol in ambulatory arthroscopy. Fifty ASA I–II adult patients who underwent knee arthroscopy were randomized to receive desflurane (D) or propofol (P) infusion accompanied by remifentanil and nitrous oxide during maintenance, titrated to maintain a bispectral index value between 50 and 60. Initial awakening, fast-track eligibility, and home readiness as well as intraoperative hemodynamics, were compared. The groups did not differ with respect to demographics, duration of operation, or intraoperative vital signs. Although the times for initial awakening parameters were shorter in group D, the differences between the groups were not significant. The time needed for the White fast-track score to reach 12 was shorter in group P than group D (9 ± 3.5 min vs 12.5 ± 5.3 min). However, home readiness did not differ significantly between the groups. Desflurane is an alternative to propofol for BIS-guided ambulatory anesthesia. Using desflurane in combination with opioid analgesics blunted its rapid emergence characteristics, and the higher frequency of emetic symptoms with desflurane diminished the success of its fast-track eligibility.