Anaesthesia for day-care arthroscopy. A comparison between desflurane and isoflurane.

A study was undertaken to compare desflurane- and isoflurane-based anaesthesia in patients undergoing day-care arthroscopic surgery. Anaesthesia was induced with propofol 2-3 mg.kg-1 and a laryngeal mask airway was inserted after loss of the eyelash reflex. Patients were then randomly divided into two groups to receive maintenance anaesthesia with either isoflurane or desflurane delivered in oxygen and nitrous oxide. Alfentanil was used as the analgesic during the operation. Early recovery was assessed by measurement of the times to eye opening, extubation and ability to give a date of birth. Psychomotor recovery was assessed by performance on the finger tapping and perceptive accuracy tests. Mood was evaluated using visual analogue mood scores and the mood adjective checklist. Discharge times were also measured. Early recovery was significantly quicker following desflurane anaesthesia but no differences between the groups were found in psychomotor tests. The mood adjective checklist showed that patients in the isoflurane group had a greater total mood score and were more calm than those in the desflurane group; this was particularly evident 2 h after anaesthesia. The discharge times were similar for the two groups. Desflurane is a satisfactory alternative to isoflurane for day care anaesthesia.

Assessment of recovery following day-case arthroscopy. A comparison between propofol and isoflurane-based anaesthesia.

Fifty healthy patients, aged 15-45 years, undergoing day-case arthroscopy, participated in a study to assess aspects of recovery and mood. Psychomotor tests, including the p-deletion test and the Trieger dot test, were performed pre-operatively and mood was measured using the mood adjective checklist. Anaesthesia in all patients was induced with propofol and a laryngeal mask airway was inserted immediately. All patients received alfentanil as the intra-operative analgesic. The patients were randomly allocated to receive one of two different regimens for maintenance of anaesthesia: propofol group--maintenance with an infusion of propofol 10 mg.kg-1.h-1 for 15 min followed by 6 mg.kg-1.h-1 and nitrous oxide and oxygen (bolus doses of propofol were given if anaesthesia was deemed to be light); isoflurane group--maintenance with isoflurane (inspired concentration 0.5-2.0%) in nitrous oxide and oxygen. Postoperatively, psychomotor tests were repeated every 30 min and mood was measured after 2 h and 24 h. Psychomotor recovery was quicker in the isoflurane group than the propofol group and had returned to baseline values in the isoflurane group by 60 min. The time to discharge was similar in both groups as was the incidence of side effects. There was no difference in mood scores between the groups either at the time of discharge or at 24 h. We conclude that psychomotor recovery is somewhat quicker when isoflurane-based anaesthesia is used for day-case arthroscopy, but other factors, including time to awakening, mood and time to discharge are similar for both techniques.