Safety and consumption of sevoflurane versus desflurane using target controlled anesthesia in children

BackgroundRecently a concept of target controlled inhalational anesthesia (TCA) is introduced in which the fresh gas flow and its composition are automatically delivered to the patients with the least possible flow. The aim of this study is to compare safety, consumption and cost of both sevoflurane and desflurane when delivered by target controlled anesthesia (TCA) using fully closed circuit conditions.Patient and methodAfter approval of the hospital review board and obtaining parental informed consent, 60 pediatric patients aged 2–12 were selected. The patients were classified into two groups according to the anesthetic used S Group (n = 30) in which sevoflurane D Group (n = 30): in which desflurane was used. Both were delivered by auto control mode of Zeus machine. Anesthetic agent and O2 consumption, cost and number of adjustments were assessed. Blood samples were obtained preoperatively and at 24, 48 and 72 h after the end of surgery for measuring serum creatinine, BUN, AST and ALT. Twenty-four hour urine samples were collected for 3 consecutive days to measure glucose, microprotein and creatinine for the estimation of creatinine clearance.ResultsThis study revealed that sevoflurane group had a lower O2, anesthetic consumption and cost than desflurane group. Also both groups had higher levels of serum urea and creatinine together with urinary microproteins and glucose in the first three post-operative days compared to preoperative values which indicates minor tubular insult. However there was no statistically significant difference between the two groups.ConclusionSevoflurane is as safe as desflurane when delivered by auto control mode of Zeus machine with decreased anesthetic consumption and cost.