Desflurane versus propofol in post-operative quality of recovery of patients undergoing day laparoscopic cholecystectomy. Prospective, comparative, non-inferiority study.
OBJECTIVE
Recently, the evaluation of postoperative results has focused on the opinion of the patient as of great relevance. Our objective was to evaluate the quality of recovery by questionnaire (QoR-15) in patients undergoing laparoscopic cholecystectomy, comparing desflurane versus a total intravenous technique with propofol (TIVA). A non-inferiority hypothesis was proposed between both techniques.


MATERIAL AND METHODS
Prospective longitudinal cohort study in patients undergoing laparoscopic cholecystectomy in which multimodal management was applied including low pneumoperitoneum pressures, deep neuromuscular block and pain prevention strategy and PONV. Anaesthesia maintenance was performed with either desflurane or propofol at the discretion of the anaesthesiologist. QoR-15 was evaluated pre-and 24hours after surgery.


RESULTS
Sixty-one patients were evaluated: 29 in the desflurane group and 32 in the TIVA group with no differences in demographic parameters, ASA grade, and preoperative QoR-15 questionnaire. The duration of the intervention was superior in TIVA group, 55 ± 15 vs. 45 ± 9min in desflurane group; p =.05. The desflurane group received more fentanyl than the TIVA group: 200 ± 65 vs. 113 ± 38μg; p =.05. No differences in pain, PONV or time of stay between groups. QoR-15 at 24h decreased 7% relative to baseline, with no differences between groups.


CONCLUSIONS
The quality of recovery evaluated by the patient was as favourable in the patients of the desflurane group as in those of the TIVA group in patients undergoing laparoscopic cholecystectomy as outpatients.
['Zaballos|M|M|', 'Reyes|A|A|', 'Etulain|J|J|', 'Monteserín|C|C|', 'Rodríguez|M|M|', 'Velasco|E|E|']
D000328:Adult D000762:Anesthesia Recovery Period D000769:Anesthesia, Inhalation D000771:Anesthesia, Intravenous D018685:Anesthetics, Inhalation D018686:Anesthetics, Intravenous D017081:Cholecystectomy, Laparoscopic D000077335:Desflurane D005260:Female D005283:Fentanyl D006801:Humans D007902:Length of Stay D008297:Male D008875:Middle Aged D019148:Neuromuscular Blockade D017060:Patient Satisfaction D011028:Pneumoperitoneum, Artificial D011183:Postoperative Complications D015742:Propofol D011446:Prospective Studies D011795:Surveys and Questionnaires
Desflurane Propofol Quality of recovery Laparoscopic cholecystectomy Ambulatory surgery Calidad de recuperación Cirugía ambulatoria Colecistectomía laparoscópica Desflurano