A Prospective Randomized Study to Compare Sevoflurane and Desflurane for Emergence and Recovery Characteristics in Pediatric Patients

Abstract

Background: Emergence and recovery have been found to be common problems after general anesthesia, especially in children. Both sevoflurane and desflurane have fast emergence and recovery from anesthesia which results in emergence delirium (ED). This study aims to compare the incidence of ED and rate of recovery in pediatric patients under sevoflurane and desflurane anesthesia. Materials and Methods: Seventy children aged 1 to 10 years belonging to American Society of Anesthesiologists physical status I or II were enrolled and randomly allocated into two groups. Group D (n = 35) received inhalational desflurane, whereas Group S (n = 35) received inhalational sevoflurane at 1.3 minimum alveolar concentration with oxygen and nitrous oxide for maintenance of anesthesia in both the groups. Rate of recovery from anesthesia (emergence time and recovery time) and incidence of ED were assessed in both the groups. Postanesthesia care unit (PACU) discharge time, hemodynamic changes, and side effects were also noted. Results: Emergence and recovery times were significantly shorter in Group D than Group S: (4.50 ± 1.53 minutes versus 6.25 ± 1.64 minutes) and (6.79 ± 1.52 minutes versus 9.12 ± 2.32 minutes), respectively (P < 0.001). No significant difference was observed in the incidence of ED in the two groups (P = 0.782). Mean PACU discharge time was significantly shorter in Group D than Group S (P < 0.001). No significant hemodynamic changes and side effects were noted in both the groups (P > 0.05). Conclusion: The incidence of ED was found to be similar with both sevoflurane and desflurane. Although the rate of recovery was significantly faster with desflurane, it was clinically insignificant. Hence, we inferred that both agents can be used safely in children, but sevoflurane should be preferred owing to its properties and cost-effectiveness particularly in our setup.