• K L Karlsen, E Persson, E Wennberg, and O Stenqvist.
• Department of Anaesthesia and Intensive Care, Sahlgrenska University Hospital, Göteborg, Sweden.
• Acta Anaesthesiol Scand. 2000 Apr 1;44(4):489-93.

BackgroundWhereas induction and recovery will occur more rapidly with the new low soluble anaesthetics than with isoflurane, the quality of anaesthesia and recovery with special emphasis on postoperative nausea and vomiting (PONV) is not well known.MethodsIn an open (peroperatively), double-blinded (postoperatively), randomised controlled study, we assessed anaesthesia characteristics, recovery and 24 h PONV after breast surgery comparing isoflurane, desflurane and sevoflurane.ResultsThere were no significant quality differences between the three agents during anaesthesia and recovery except for the incidence of PONV in the postanaesthesia care unit (PACU). The PONV rate (24 h in PACU and ward) was higher in the desflurane group (67%) than in the isoflurane group (22%), (P<0.01). The corresponding PONV rate for sevoflurane was 36%.ConclusionThe quality of anaesthesia, time to opening of eyes and influence on respiration was similar with all three anaesthetics. As the emergence from anaesthesia did not differ significantly between the three agents, the choice of agent could be based on PONV rate and price. Desflurane had a significantly higher 24 h PONV rate than isoflurane. Early PACU PONV rate was significantly (P<0.05) lower for the more soluble isoflurane (4%) than for the low soluble gases, desflurane and sevoflurane together (28%). The result of this study does not give a rationale for a transition to the new low soluble agents in breast cancer surgery.

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