Hobbhahn, J and Schwall, B and Prasser, C and Vogel, H and Taeger, K (1997) Induction, emergence and recovery with sevofluran and desfluran in comparison to other inhalation anaesthetics and propofol. ANASTHESIOLOGIE & INTENSIVMEDIZIN, 38 (12). pp. 607-615. ISSN 0170-5334,
Full text not available from this repository.Abstract
The pharmakokinetics of the volatile anaesthetics sevoflurane and desflurane differ markedly from halothane, isoflurane and enflurane, The following survey will discuss how the pharmacocinetic profile of sevoflurane and desflurane affects clinical practice focussing upon induction, emergence and the period in the postanaesthesia care unit (PACU), The comparison will include the "old" inhalation anaesthetics and propofol, the latter standing for a rapid and pleasant recovery from anaesthesia, In children, induction with sevoflurane is achieved more rapidly than with halothane while the rate of complications is comparably low Most of the adult patients rated induction with sevoflurane as pleasant and would choose sevoflurane induction with a similar preference as propofol induction, With desflurane, however, induction of anaesthesia is potentially difficult and complicated in children as well as in adults, Compared to the "old" inhalation anaesthetics, emergence times and recovery of cognitive functions are more rapid after sevoflurane and desflurane and similar or even superior to propofol, Respiratory function and protective reflexes are less attenuated after sevoflurane and desflurane, compared to halothane and isoflurane, This might be relevant for patients presenting with impaired respiratory function, Shivering occurs with the same frequency following sevoflurane and desflurane as following isoflurane, enflurane or propofol, Postoperative nausea and vomiting (PONV) after sevoflurane and desflurane occur as often or less often as after the "old" inhalation anaesthetics, Compared to propofol, desflurane is associated with a high incidence of PONV, This, however, can be effectively counteracted with potent antiemetics. Pain is often recognized earlier and more intensively in children after the new inhalation anaesthetics compared to halothane and this may be associated with agitation, Furthermore, a higher demand for analgesics has been shown in children following anaesthesia with sevoflurane and desflurane, In adult patients, few studies report an earlier request for analgesics, but the need for analgesics is not increased, neither in comparison to isoflurane nor to propofol, Most studies performed in children with sevoflurane and halothane showed a shorter stay in the recovery room after sevoflurane. With some exceptions, this could not be shown in adults, if the new inhalation anaesthetics are compared with isoflurane. The stay in the PACU after sevoflurane has consistently been shown to be similar to that after propofol, Desflurane was associated with a later discharge compared to propofol in some studies due to prolonged PONV, In conclusion, the new inhalation anaesthetics are a valuable addition to the spectrum of anaesthetics, This applies particularly to sevoflurane, because of its universal application and its propofol-like features, e,g, rapid and pleasant recovery from anaesthesia.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | OUTPATIENT GYNECOLOGICAL LAPAROSCOPY; PEDIATRIC AMBULATORY PATIENTS; NITROUS-OXIDE; ISOFLURANE ANESTHESIA; COGNITIVE FUNCTIONS; SURGICAL PATIENTS; OPEN-LABEL; PHASE-III; HALOTHANE; MAINTENANCE; anaesthetics, inhalation; propofol; anaesthesia recovery period; anaesthesia |
| Depositing User: | Dr. Gernot Deinzer |
| Last Modified: | 19 Oct 2022 08:30 |
| URI: | https://pred.uni-regensburg.de/id/eprint/50341 |
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