16: Is emergence from sevoflurane substantially faster than from isoflurane?

We investigate the claim that emergence from sevoflurane is substantially faster than from isoflurane. We explore rationales and discuss cost.  Our guest today is Dr. Keith Baker, Vice Chair of Education at Massachusetts General Hospital.  Connect with us @DepthAnesthesia on Twitter or email us at [email protected]. Thanks for listening! Please rate us on iTunes and share with your colleagues.  Music by Stephen Campbell, MD.  __ References Seitsonen ER, Yli-Hankala AM, Korttila KT. Similar recovery from bispectral index-titrated isoflurane and sevoflurane anesthesia after outpatient gynecological surgery. J Clin Anesth. 2006;18(4):272-279. doi:10.1016/j.jclinane.2005.12.005 Gupta A, Stierer T, Zuckerman R, Sakima N, Parker SD, Fleisher LA. Comparison of recovery profile after ambulatory anesthesia with propofol, isoflurane, sevoflurane and desflurane: a systematic review. Anesth Analg. 2004;98(3):. doi:10.1213/01.ane.0000103187.70627.57 Gauthier A, Girard F, Boudreault D, Ruel M, Todorov A. Sevoflurane provides faster recovery and postoperative neurological assessment than isoflurane in long-duration neurosurgical cases. Anesth Analg. 2002;95(5):. doi:10.1097/00000539-200211000-00052 Ries CR, Azmudéh A, Franciosi LG, Schwarz SK, MacLeod BA. Cost comparison of sevoflurane with isoflurane anesthesia in arthroscopic menisectomy surgery. Can J Anaesth. 1999;46(11):1008-1013. doi:10.1007/BF03013193 Maheshwari K, Ahuja S, Mascha EJ, et al. Effect of Sevoflurane Versus Isoflurane on Emergence Time and Postanesthesia Care Unit Length of Stay: An Alternating Intervention Trial. Anesth Analg. 2020;130(2):360-366. doi:10.1213/ANE.0000000000004093 Yasuda N, Targ AG, Eger EI 2nd. Solubility of I-653, sevoflurane, isoflurane, and halothane in human tissues. Anesth Analg. 1989;69(3):370-373. __ By listening to this podcast, you agree not to use information as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Opinions expressed are solely those of the host and guests and do not express the views or opinions of Massachusetts General Hospital.

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Depth of Anesthesia is a podcast that critically explores dogmatic practices (we call them claims) in anesthesiology. Join us as we explore the literature around the latest clinical controversies!