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NEUROSURGICAL ANESTHESIA

The Effect of Desflurane and Sevoflurane on Cerebral Oximetry Under Steady-State Conditions

Department of Anesthesiology, Aretaieion Hospital, Athens, Greece

Address correspondence and reprint requests to Argyro Fassoulaki MD, PhD, DEAA, 57-59 Raftopoulou Street, 11744 Athens, Greece. Address e-mail to afassou1{at}otenet.gr or fassoula{at}aretaieio.uoa.gr.

We studied the effect of sevoflurane and desflurane on regional cerebral oxygenation (rSO₂). Twenty-two patients undergoing abdominal hysterectomy received sevoflurane and desflurane for 15 min each and 30 min apart under steady-state conditions in a randomized, crossover manner to maintain a bispectral index (BIS) of 40–50. In another 22 patients undergoing the same anesthesia and surgery BIS was maintained at 20–30. During the 15-min administration of each anesthetic at steady-state conditions rSO₂, BIS, inspired and end-tidal anesthetic concentrations, end-tidal CO₂, Spo₂, systolic and diastolic blood pressures, and heart rate were recorded every 3 min. The rSO₂ did not differ between sevoflurane and desflurane when BIS values were maintained between 40–50 or 20–30. The MAC_BIS values required to maintain BIS at 40–50 and at 20–30 were 1.0 versus 1.2 (P = 0.004) and 1.6 versus 1.8 (P < 0.001) for desflurane and sevoflurane respectively. Higher rSO₂ values were obtained by 1.6 MAC (71 ± 13) than by 1 MAC of desflurane (66 ± 10; P < 0.001) and by 1.8 MAC (72 ± 11) than by 1.2 MAC of sevoflurane (66 ± 13; P < 0.001). In conclusion, equipotent concentrations of desflurane or sevoflurane in terms of BIS are associated with similar rSO₂ values, but larger anesthetic concentrations of both anesthetics increased the rSO₂ values.