A Observational Study of Desflurane Versus Sevoflurane in Obese Patients Undegoing Laparoscopic Surgery

Abstract

INTRODUCTION

Obesity is a significant health concern worldwide, and its prevalence has been steadily increasing over the past few decades. Obese individuals often require surgical interventions for various medical conditions, including laparoscopic procedures. Anaesthesia management plays a crucial role in ensuring patient safety and optimizing surgical outcomes in this population. Anaesthesia in obese patient is difficult due to associated multimorbidity and modified physiology.

Inhaled volatile anaesthetics, such as desflurane and sevoflurane, are commonly used in general anaesthesia for laparoscopic surgery. Both agents have desirable characteristics, including rapid onset and offset, minimal metabolism, and low tissue solubility. However, their effects and considerations may differ in obese patients due to physiological and pharmacokinetic alterations associated with obesity.

Desflurane and sevoflurane have a low-fat-blood solubility hence, the results in a moderately rapid induction, recovery and rate of change of anaesthetic depth differs. Desflurane has a blood gas solubility coefficient of 0.42 the lowest of all the inhalational agent which recovery should occur rapidly. The agent has advantage when used in extreme of age and in the obese. Sevoflurane is an ether inhalational agent with non-inflammable compound with low solubility profile and blood gas partition co efficient. The motive of the study is to compare desflurane and sevoflurane unique properties that influence the time taken for recovery and the hemodynamic changes the occurs to their obese patient undergoing laparoscopic surgery

AIM

The main aim of this study is to evaluate and compare desflurane and sevoflurane in obese patient undergoing laparoscopic surgery.

METHODOLOGY

The study was conducted in 40 patients belonging to either gender. After obtaining informed concern from each patient, the patients were selected and divided into two, Group D and Group S, each group containing 20 patients.

Group D was given Desflurane and Group S was given Sevoflurane.

RESULTS

Intraoperative MAP and HR did not differ between the two groups. The time to response to painful stimuli, obeying verbal commands and spontaneous eye opening, limb elevation and ability to cough and swallow was shorter in desflurane anaesthesia than sevoflurane.

CONCLUSION

Both desflurane and sevoflurane produce similar hemodynamic changes but the immediate and intermediate recovery was significantly faster after desflurane thus contributing to fast tracking and early discharge of patients.