Research & Innovation in Anesthesia

Register      Login

VOLUME 3 , ISSUE 1 ( 2018 ) > List of Articles


A Prospective, Randomized Single-blind Study of Sevoflurane vs Desflurane, with Dexmedetomidine, on the Intraoperative Hemodynamics and Postoperative Recovery for Transsphenoidal Pituitary Surgery

Anjana Wajekar, Ruchi A Jain, Anita Shetty

Keywords : Desflurane, Dexmedetomidine, Sevoflurane, Transsphenoidal pituitary surgeries.

Citation Information : Wajekar A, Jain RA, Shetty A. A Prospective, Randomized Single-blind Study of Sevoflurane vs Desflurane, with Dexmedetomidine, on the Intraoperative Hemodynamics and Postoperative Recovery for Transsphenoidal Pituitary Surgery. Res Inno Anesth 2018; 3 (1):13-17.

DOI: 10.5005/jp-journals-10049-0041

License: CC BY-SA 4.0

Published Online: 01-03-2017

Copyright Statement:  Copyright © 2018; The Author(s).


Introduction: The anesthesia goals for transsphenoidal pituitary surgeries include intraoperative hemodynamic stability and early postoperative recovery for cranial nerve evaluation. In this study, we aim to compare the intraoperative hemodynamics and postoperative recovery of sevoflurane with desflurane in a dexmedetomidine-based general anesthesia. Materials and methods: Sixty patients, 18 to 65 years, American Society of Anesthesiologists (ASA) grades I and II, with Glasgow Coma Scale 15/15 were included. Thirty patients each were randomly divided into group S (sevoflurane) and group D (desflurane). The primary objective was to compare the intraoperative hemodynamics. Secondary objectives were to assess the total dose of dexmedetomidine, number of propofol doses, time to extubate, agitation score at emergence, and modified Aldrete score. The anesthesia management included an intravenous induction followed by maintenance with inhalational agent in oxygen: Nitrous oxide mixture (50%), dexmedetomidine infusion, and rescue doses of propofol. Results: Heart rate (HR) and mean arterial pressure (MAP) were similar in both the groups except MAP just 5 minutes postincision, which was higher in group S (p < 0.001). There were no differences in intraoperative dexmedetomidine use, propofol bolus doses or time to extubate. But the agitation score was higher in group S (p < 0.001). The modified Aldrete score was higher in group D at 5, 15, 30, and 60 minutes (p < 0.001). Conclusion: Both desflurane and sevoflurane produce a similar intraoperative hemodynamic response in a dexmedetomidinebased general anesthesia except sevoflurane, in the doses used in our study was insufficient to attenuate the hypertensive response to incision. With regard to emergence agitation and recovery profile, desflurane appears to be a superior agent.

PDF Share
  1. Horvat A, Kolak J, Gopceviæ A, Ilej M, Zivko G. Anesthetic management of patients undergoing pituitary surgery. Acta Clin Croat 2011 Jun;50(2):209-216.
  2. Jain RA, Shetty AN, Oak SP, Wajekar AS, Garasia MB. Effects of avoiding neuromuscular blocking agents during maintenance of anaesthesia on recovery characteristics in patients undergoing craniotomy for supratentorial lesions: a randomised controlled study. Indian J Anaesth 2017 Jan;61(1):42-47.
  3. Dube SK, Pandia MP, Chaturvedi A, Bithal P, Dash HH. Comparison of intraoperative brain condition, hemodynamics and postoperative recovery between desflurane and sevoflurane in patients undergoing supratentorial craniotomy. Saudi J Anaesth 2015 Apr-Jun;9(2):167-173.
  4. Magni G, Rosa IL, Melillo G, Savio A, Rosa G. A comparison between sevoflurane and desflurane anesthesia in patients undergoing craniotomy for supratentorial intracranial surgery. Anesth Analg 2009 Aug;109(2):567-571.
  5. Nemergut EC, Dumont AS, Barry UT, Laws ER. Perioperative management of patients undergoing transsphenoidal pituitary surgery. Anesth Analg 2005 Oct;101(4):1170-1181.
  6. Nathanson MH, Fredman B, Smith I, White PF. Sevoflurane versus desflurane for outpatient anesthesia: a comparison of maintenance and recovery profiles. Anesth Analg 1995 Dec;81(6):1186-1190.
  7. Kaur A, Jain AK, Sehgal R, Sood J. Hemodynamics and early recovery characteristics of desflurane versus sevoflurane in bariatric surgery. J Anaesthesiol Clin Pharmacol 2013 Jan;29(1):36-40.
  8. Ebert TJ, Muzi M. Sympathetic hyperactivity during desflurane anesthesia in healthy volunteers. A comparison with isoflurane. Anesthesiology 1993 Sep;79(3):444-453.
  9. Inada T, Inada K, Kawachi S, Takubo K, Tai M, Yasugi H. Haemodynamic comparison of sevoflurane and isoflurane anaesthesia in surgical patients. Can J Anaesth 1997 Feb;44(2):140-145.
  10. Kim HJ, Kim DK, Kim HY, Kim JK, Choi SW. Risk factors of emergence agitation in adults undergoing general anesthesia for nasal surgery. Clin Exp Otorhinolaryngol 2015 Mar;8(1):46-51.
  11. Costi D, Cyna AM, Ahmed S, Stephens K, Strickland P, Ellwood J, Larsson JN, Chooi C, Burgoyne LL, Middleton P. Effects of sevoflurane versus other general anaesthesia on emergence agitation in children. Cochrane database Syst Rev 2014 Sep;9:CD007084.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.