Desflurane accelerates patient response during the wake-up test for scoliosis surgery

Abstract

Purpose: To evaluate if desfurane possesses a shorter wake-up onset time and less incidence of recall than fentanyl-based anesthesia. Methods: Forty 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. Results: Patients 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. Conclusions: DES 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.