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ISSN 2063-5346
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A COMPARATIVE EVALUATION OF EFFECTS OF DESFLURANE AND SEVOFLURANE ANAESTHESIA ON EMERGENCE CHARACTERISTICS AND EARLY POSTOPERATIVE COGNITIVE FUNCTION AFTER NEUROSURGICAL PROCEDURES

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Dr. Tanushree Srivastava1* , Dr. Monika Singh2 , Dr. Sumi Saxena
» doi: 10.48047/ecb/2023.12.si5a.0268

Abstract

Background: Timely recovery from anaesthesia is an important goal after any surgery, be it a day-care procedure or a major surgery. It ensures patient safety such that the patient is able to maintain a clear airway, exhibit protective airway reflexes and respiration as well as oxygenation are satisfactory. It decreases the risk of post-operative cognitive dysfunction. It may also facilitate early transfer of the patient from the operating room and the post-anaesthesia care unit and hence reduce costs4. One of the major factors determining the speed of recovery from anaesthesia is the choice of anaesthetic technique. An ideal general anaesthetic should provide smooth and rapid induction, optimal operating conditions and rapid recovery with minimal side effects. Newer less soluble inhalational agents such as desflurane and sevoflurane are now available. They allow rapid recovery from anaesthesia compared to the traditional inhalational agents and intravenous agents. Aim and Objectives: To comparatively assess recovery characteristics following desflurane and sevoflurane anaesthesia in neurosurgery patients, to comparatively evaluate the early post-operative cognitive function between both the groups and to assess and compare postoperative adverse events. Materials and Methods: The patients were divided into two groups using Block Randomisation in blocks of four patients each. Group S- received Sevoflurane as maintenance anaesthetic agent and Group D- received Desflurane as maintenance anaesthetic agent. The following parameters for each patient were noted and compared: Haemodynamic variations in the two groups, Emergence characteristics i.e. time from discontinuing nitrous oxide and inhalational agent to Eye Opening, following commands, Hand squeeze, Tracheal extubation, Orientation to place and person. Pre- and Postoperative scores of the cognitive function tests (SOMCT, DSST and TDT) at 30, 60 and 90 minutes and Postoperative adverse events, if any. Statistical analysis was done using paired and unpaired student’s t-test, chi square test and Mann-Whitney tests. For all statistical comparisons in this study, p<0.05 was taken as significant. Discussion and Conclusion: It can be concluded that newer inhalational agents, desflurane and sevoflurane, both provide rapid emergence and faster recovery of cognitive functions postoperatively. Desflurane, compared to sevoflurane, is associated with a more rapid awakening, earlier return of orientation and less cognitive function impairment in neurosurgical procedures. The earlier awakening, orientation and more rapid recovery after desflurane might have a significant beneficial effect in neurosurgical patients as postoperative neurological assessment can be performed early and complications can be suspected and diagnosed quicker

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