Der Anaesthesist
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Randomized Controlled Trial Comparative Study Clinical Trial
[Changes in somatosensory evoked potentials after sevoflurane and isoflurane. A randomized phase III study].
Monitoring of somatosensory evoked potentials (SEP) is used to identify critical phases of cerebral ischaemia by means of characteristic changes in the signal patterns. A correct interpretation of the results is possible, however, only if the influence of drugs that act on the central nervous system is known. We were able to show that volatile anaesthetics have an impact on latencies and stimulus amplitudes. ⋯ Under the influence of N2O, there were marked reductions in amplitude of the cortical stimulus response. Thus, it can be recommended that supplementation with N2O should be avoided in the presence of low initial amplitudes. Based on our results, the use of isoflurane and sevoflurane concentrations up to 1.0 MAC seems to be compatible with intraoperative monitoring of SEP.
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Randomized Controlled Trial Multicenter Study Clinical Trial
[Comparison of sevoflurane and isoflurane in ambulatory surgery. Results of a multicenter study].
A multicenter, randomized, comparative phase III study evaluating the effect of sevoflurane versus isoflurane in adult outpatients was performed. The aim of the study was to compare (1) maintenance of anaesthesia and (2) how rapidly and easily the patients emerge from the anaesthetic and recover. ⋯ Sevoflurane was as safe as isoflurane for anaesthesia in adult outpatients. Patients who received sevoflurane had statistically significantly shorter recovery parameters than isoflurane patients.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
[The cardiovascular effects of sevoflurane].
The cardiovascular effects of sevoflurane as published from clinical and experimental studies are reviewed with respect to general haemodynamics and organ perfusion. Sevoflurane appears to be quite similar to isoflurane, with some minor exceptions. In adult patients and volunteers, sevoflurane has not been associated with increases in heart rate, whereas isoflurane and desflurane caused significant increases in heart rate at higher concentrations. ⋯ In several multi-center studies where patients with coronary artery disease or at high risk for coronary artery disease were randomised to receive either sevoflurane or isoflurane for cardiac or non-cardiac surgery, the incidence of myocardial ischaemia and infarction did not differ between treatment groups. In both human and animal models, sevoflurane preserves cerebral blood flow and reduces cerebral metabolic rate much like isoflurane. Considering its favourable pharmacokinetic properties, the introduction of sevoflurane into clinical practice appears to be a promising extension of the anaesthetic spectrum.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Awakening from anesthesia and recovery of cognitive function after desflurane or isoflurane].
Desflurane is a new volatile anaesthetic with an extremely low blood/gas partition coefficient of 0.42. This should provide a rapid recovery from anaesthesia. ⋯ Our results demonstrate that desflurane anaesthesia, even when supplemented by premedication, intraoperative opioids, and nitrous oxide may offer clinical advantages over isoflurane as far as the post-anaesthetic recovery profile is concerned.
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Randomized Controlled Trial Comparative Study Clinical Trial
[A comparative study of the use of sevoflurane and propofol in ambulatory surgery].
Cost-containment strategies increase the demand for day-case surgery. In outpatients, a short time of stay in the post-anaesthesia care unit and a short interval to discharge home are of great importance. After general anaesthesia, mental and psychomotor functions are impaired to varying degrees by different anaesthetics. Therefore, the choice of anaesthetic may influence the discharge times of outpatients. In this study, the recovery characteristics of sevoflurane versus propofol anaesthesia were compared in adult outpatients. ⋯ The results indicate that in urological and ophthalmological day surgery, the early recovery and the return of mental and psychomotor function in the first 60 min after anaesthesia is faster following sevoflurane than after propofol. No differences in ambulation times became evident. Sevoflurane may offer clinical advantages over propofol when used for maintenance of anaesthesia during outpatient surgical procedures.