• Chien-Kun Ting, Jenkin S Hu, Yun-Hui Teng, Ya-Ying Chang, Mei-Yung Tsou, and Shen-Kou Tsai.
• Department of Anesthesiology, Veterans General Hospital-Taipei, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
• Can J Anaesth. 2004 Apr 1;51(4):393-7.

PurposeTo evaluate if desflurane possesses a shorter wake-up onset time and less incidence of recall than fentanyl-based anesthesia.MethodsForty ASA class I-II adolescents, were enrolled into either a desflurane (DES) group, or a fentanyl (FEN) group for scoliosis surgery. Bispectral index (BIS) was monitored continuously in all patients throughout the procedure; the relationship between the wake-up time and BIS value was evaluated.ResultsPatients in the DES group had a significantly shorter wake-up onset than patients in the FEN group (4.1 +/- 0.6 vs 8.9 +/- 2.1 min, P < 0.01). No recall occurred during the wake-up test in the DES group, while five patients had recall in the FEN group, including two patients who recalled a given colour. Extubation time was significantly shorter in the DES group than in the FEN group (7.2 +/- 0.6 vs 16 +/- 11.9 min, P < 0.01). BIS values were significantly higher in the FEN group than in the DES group during anesthesia. (62 +/- 4.5 vs 42 +/- 5.3, P < 0.05) BIS after the wake-up test was similar in both groups (90 +/- 2.9 vs 93.8 +/- 2.5). There was a latency period (3.3 +/- 1.2 min) between the maximal BIS value and wake-up time in the FEN group but not in the DES group.ConclusionsDES provides a significantly shorter onset time during the wake-up test and a rapid emergence after scoliosis surgery. BIS monitoring during the wake-up test was more informative when anesthesia was maintained with DES compared to FEN infusion.

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