Sevoflurane vs. isoflurane: a clinical comparison in day surgery

Discharge times after ambulatory surgery are determined by postoperative complications and in particular by the presence and severity of nausea and vomiting. Sevoflurane has become a popular agent for day-case surgery despite little evidence of clear advantages over current alternatives. We compared this agent with isoflurane in day-case patients undergoing knee arthroscopy in order to quantify the incidence of complications associated with each agent. One hundred and eighty patients received a standardised anaesthetic induction with propofol and fentanyl followed by maintenance with either isoflurane or sevoflurane. Standardised postoperative analgesic and anti-emetic drugs were prescribed. Any intra-operative cardiovascular or respiratory instability was recorded. After surgery, nausea, vomiting and pain were assessed. Almost all patients made an uneventful recovery and were discharged as scheduled. There was a significantly higher incidence of complications in the sevoflurane group. These included nausea and vomiting, cardiovascular and respiratory complications.