Isoflurane v Fentanyl for Outpatient Laparoscopy

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Abstract
Isoflurane and fentanyl were compared as anesthetic agents for outpatient laparoscopy. In 50 female patients, anesthesia was induced with thiopentone, and was maintained with N2O 66% in O2 combined with either isoflurane 1-2% or fentanyl 0.3 mg, according to a radomized list. Suxamethonium was used to facilitate intubation and for further muscle relaxation. Immediate recovery from anesthesia was assessed by eye opening and time before giving the date of birth. Additional observations made hourly for 4 h were: nausea or vomiting; clinical assessment of wakefulness; psychic or motor agitation; antiemetic or analgesic drugs given; reaction time; respiratory depression. Immediate recovery was more rapid in the fentanyl group (P < 0.05). Reaction times in the isoflurane patients returned to control by 3 h, whereas the fentanyl patients were 10% slower than control at 4 h (P < 0.05 at 2 h, 3 h, 4 h). Nausea and vomiting were more frequent in the fentanyl group, and 4 of the fentanyl patients required naloxone. Both anesthetic techniques provided satisfactory operating conditions, but isoflurane appeared to provide a better recovery, with less side effects than fentanyl.