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Anaesthetic agents in adult day case surgery

  • B. J. Pollard (a1), R. A. Elliott (a1) and E. W. Moore (a2)


This study reports a review of all comparative published studies of adult day case anaesthesia in the English language up to December 2000. Ten databases were searched using appropriate keywords and data were extracted in a standardized fashion. One hundred-and-one published studies were examined. Recovery measurements were grouped as early, intermediate, late, psychomotor and adverse effects. With respect to induction of anaesthesia, propofol was superior to methohexital, etomidate and thiopental, but equal to sevoflurane and desflurane. Desflurane and sevoflurane were both superior to thiopental. There was no detectable difference between sevoflurane and isoflurane. With respect to the maintenance of anaesthesia, isoflurane and halothane were the worst. There were no significant differences between propofol, desflurane, sevoflurane and enflurane. Propofol is the induction agent of choice in day case patients. The use of a propofol infusion and avoidance of nitrous oxide may help to reduce postoperative nausea and vomiting.

Corresponding author
Correspondence to: Brian Pollard, University Department of Anaesthesia, Manchester Royal Infirmary, Manchester, M13 9WL, UK. E-mail:; Tel: +44 (0)161 276 8650; Fax: +44 (0)161 273 5685
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GuptaA, LarsenLE, SjobergF, LindhML, LennmarkenC. Thiopentone or propofol for induction of isoflurane-based anaesthesia for ambulatory surgery.Acta Anaesthesiol Scand1992; 36: 670674.

KashtanH, EdelistG, MallonJ, KapalaD. Comparative evaluation of propofol and thiopentone for total intravenous anaesthesia.Can J Anaesth1990; 37: 170176.

KorttilaK, NuottEJ, LichtorL, et al. Clinical recovery and psychomotor function after brief anaesthesia with propofol or thiopental.Anesthesiology1992; 76: 676681.

KorttilaK, OstmanP, FaureE, et al. Randomized comparison of recovery after propofol–nitrous oxide versus thiopentone–isoflurane–nitrous oxide anaesthesia in patients undergoing ambulatory surgery.Acta Anaesthesiol Scand1990; 34: 400403.

PriceML, WalmsleyA, SwaineC, PonteJ. Comparison of a total intravenous anaesthetic technique using a propofol infusion, with an inhalational technique using enflurane for day case surgery.Anaesthesia1988; 43: 8487.

RyomC, FlarupM, SuadicaniP, et al. Recovery following thiopentone or propofol anaesthesia assessed by computerized coordination measurements.Acta Anaesthesiol Scand1992; 36: 540545.

DingY, FredmanB, WhitePF. Recovery following outpatient anesthesia: use of enflurane versus propofol.J Clin Anesth1993; 5: 447450.

SandersLD, ClyburnPA, RosenM, RobinsonJO. Propofol in short gynaecological procedures.Anaesthesia1991; 46: 451455.

SampsonIH, PloskerH, CohenM, KaplanJA. Comparison of propofol and thiamylal for induction and maintenance of anaesthesia for outpatient surgery.Br J Anaesth1988; 61: 707711.

MoffatA, CullenPM. Comparison of two standard techniques of general anaesthesia for day-case cataract surgery.Br J Anaesth1995; 74: 145148.

De GroodPMRM, HarbersJBM, van EgmondJ, CrulJF. Anaesthesia for laparoscopy.Anaesthesia1987; 42: 815823.

PastuovicL, CohenME, BurtonRG. Propofol: an alternative general anaesthetic for outpatient oral surgery.J Oral Maxillofac Surg1996; 54: 943948.

WernerME, NewhouseRF. A comparison of propofol with methohexital and isoflurane in two general anaesthetic techniques.J Oral Maxillofac Surg1993; 51: 10761083.

SloanMF, ConardPF, KarsunkyPD, GrossJB. Sevoflurane versus isoflurane: induction and recovery characteristics with single-breath inhaled inductions of anesthesia.Anesth Analg1996; 82: 528532.

FletcherJE, SebelPS, MurphyMR, et al. Psychomotor performance after desflurane anesthesia: a comparison with isoflurane.Anesth Analg1991; 73: 260265.

FredmanB, NathansonMH, SmithI, et al. Sevoflurane for outpatient anesthesia: a comparison with propofol.Anesth Analg1995; 81: 823828.

DashfieldAK, BirtDJ, ThurlowJ, KestinIG, LangtonJA. Recovery characteristics using single-breath 8% sevoflurane or propofol for induction of anaesthesia in day-case arthroscopy patients.Anaesthesia1998; 53: 10621066.

SmithI, ThwaitesAJ. Target-controlled propofol vs. sevoflurane: a double-blind, randomised comparison in day-case anaesthesia.Anaesthesia1999; 54: 745752.

OngEL, ChiuJW, ChongJL, KwanKM. Volatile induction and maintenance (VIMA) versus total intravenous anaesthesia (TIVA) for minor gynaecological procedures.Ambulat Surg2000; 8: 3740.

FishWH, HobbsAJ, DanielsMV. Comparison of sevoflurane and total intravenous anaesthesia for daycase urological surgery.Anaesthesia1999; 54: 9991006.

ApfelbaumJL, LichtorL, LaneBS, CoalsonDW, KorttilaKT. Awakening, clinical recovery, and psychomotor effects after desflurane and propofol anesthesia.Anesth Analg1996; 83: 721725.

RappSE, ConahanTJ, PavlinDJ, et al. Comparison of desflurane with propofol in outpatients undergoing peripheral orthopedic surgery.Anesth Analg1992; 75: 572579.

WrigleySR, FairfieldJE, JonesRM, BlackAE. Induction and recovery characteristics of desflurane in day case patients: a comparison with propofol.Anaesthesia1991; 46: 615622.

GrahamSG, AitkenheadAR. A comparison between propofol and desflurane anaesthesia for minor gynaecological laparoscopic surgery.Anaesthesia1993; 48: 471475.

NathansonMH, FredmanB, SmithI, WhitePF. Sevoflurane versus desflurane for outpatient anesthesia: a comparison of maintenance and recovery profiles.Anesth Analg1995; 81: 11861190.

TaraziEM, PhilipBKA. A comparison of recovery after sevoflurane or desflurane in ambulatory anesthesia.J Clin Anesth1998; 10: 272277.

Naidu-SjosvardK, SjobergF, GuptaA. Anaesthesia for videoarthroscopy of the knee.Acta Anaesthesiol Scand1998; 42: 464471.

GuptaA, KullanderM, EkbergK, LennmarkenC. Anaesthesia for day-case arthroscopy: a comparison between desflurane and isoflurane.Anaesthesia1996; 51: 5662.

MartikainenM, Kangas-SaarelaT, LoponenA, SalomakiT. One-week recovery profiles after spinal, propofol, isoflurane and desflurane anaesthesia in ambulatory knee arthroscopy.Ambulatory Surg2000; 8: 139142.

GhouriAF, BodnerM, WhitePF. Recovery profile after desflurane–nitrous oxide versus isoflurane–nitrous oxide in outpatients.Anesthesiology1991; 74: 419424.

PhilipBK, KallarSK, BogetzMS, SchellerMS, WetchlerBV. Sevoflurane Multicenter Ambulatory Group. A multicenter comparison of maintenance and recovery with sevoflurane or isoflurane for adult ambulatory anesthesia. Anesth Analg1996; 83: 314319.

ErikssonH, HaasioJ, KorttilaK. Recovery from sevoflurane and isoflurane anaesthesia after outpatient gynaecologic laparoscopy.Acta Anaesthesiol Scand1995; 39: 377380.

PollardBJ, BryanA, BennettD, et al. Recovery after oral surgery with halothane, enflurane, isoflurane or propofol anaesthesia.Br J Anaesth1994; 72: 559566.

CarterJA, DyeAM, CooperGM. Recovery from day-case anaesthesia.Anaesthesia1985; 40: 545548.

ChungF, MulierJP, ScolzJ, et al. A comparison of anaesthesia using remifentanil combined with either isoflurane, enflurane or propofol in patients undergoing gynaecological laparoscopy, varicose vein or arthroscopic surgery.Acta Anaesthesiol Scand2000; 44: 790798.

RaederJ, GuptaA, PedersenFM. Recovery characteristics of sevoflurane- or propofol-based anaesthesia for day-care surgery.Acta Anaesthesiol Scand1997; 41: 988994.

SongD, JoshiGP, WhitePF. Fast track eligibility after ambulatory anesthesia: a comparison of desflurane, sevoflurane, and propofol.Anesth Analg1998; 86: 267273.

ErikssonH, KorttilaK. Recovery profile after desflurane with or without ondansetron compared with propofol in patients undergoing outpatient gynaecological laparoscopy.Anesth Analg1996; 82: 533538.

AshworthJ, SmithI. Comparison of desflurane with isoflurane of propofol in spontaneously breathing ambulatory patients.Anesth Analg1998; 87: 312318.

CarrollPH, OggTW, WatsonB, et al. The safety, efficacy and recovery characteristics of desflurane versus propofol for anaesthesia in an older day surgery population.Ambulatory Surg1997; 5: 8592.

JakobssonJ, HellquistE, BastosM. Cost-effective anaesthesia for outpatient arthroscopic surgery: Desflurane versus propofol?Ambulatory Surg1997; 5: 6770.

MarshallCA, JonesRM, BajorekPK, CashmanJN. Recovery characteristics using isoflurane or propofol for maintenance of anaesthesia: a double-blind controlled trial.Anaesthesia1992; 47: 461466.

ValanneJ. Recovery and discharge of patients after long propofol infusion vs isoflurane anaesthesia for ambulatory surgery.Acta Anaesthesiol Scand1992; 36: 530533.

NelskyläK, ErikssonH, SoikkeliA, KorttilaK. Recovery and outcome after propofol and isoflurane anesthesia in patients undergoing laparoscopic hysterectomy.Acta Anaesthesiol Scand1997; 41: 360363.

LarsenLE, GuptaA, LedinT, et al. Psychomotor recovery following propofol or isoflurane anaesthesia for day-care surgery.Acta Anaesthesiol Scand1992; 36: 276282.

GreenG, JonssonL. Nausea: the most important factor determining length of stay after ambulatory anaesthesia. A comparative study of isoflurane and/or propofol techniques.Acta Anaesthesiol Scand1993; 37: 742746.

GuptaA, KullanderM, EkbergK, LennmarkenC. Assessment of recovery following day-case arthroscopy.Anaesthesia1995; 50: 937942.

NightingaleJJ, LewisIH. Recovery from day-case anaesthesia: comparison of total I.V. anaesthesia using propofol with an inhalation technique.Br J Anaesth1992; 68: 356359.

OikkonenM. Propofol vs isoflurane for gynaecological laparoscopy.Acta Anaesthesiol Scand1994; 38: 110114.

CollinsSJ, RobinsonAL, HollandHF. A comparison between total intravenous anaesthesia using a propofol/ alfentanil mixture and an inhalational technique for laparoscopic gynaecological sterilization.Eur J Anaesthesiol1996; 13: 3337.

NelskylaK, KorttilaK, Hankala-YliA. A comparison of sevoflurane–nitrous oxide and propofol–alfentanil–nitrous oxide anesthesia for minor gynaecological surgery.Br J Anaesth1999; 83: 576579.

MelnickBM, JohnsonLS. Effects of eliminating nitrous oxide in outpatient anesthesia.Anesthesiology1987; 67: 982984.

ShortSM, RutherfordCF, SebelPS. A comparison between isoflurane and alfentanil supplemented anaesthesia for short procedures.Anaesthesia1985; 40: 11601164.

SukhaniR, LurieJ, JabamoniR. Propofol for ambulatory gynecologic laparoscopy: does omission of nitrous oxide alter postoperative emetic sequelae and recovery?Anesth Analg1994; 78: 831835.

LindekaerAL, SkielboeM, GuldagerH, JensenEW. The influence of nitrous oxide on propofol dosage and recovery after total intravenous anaesthesia for day-case surgery.Anaesthesia1995; 50: 397399.

ArellanoRJ, PoleML, RafuseSE, et al. Omission of nitrous oxide from a propofol-based anesthetic does not affect the recovery of women undergoing outpatient gynecologic surgery.Anesthesiology2000; 93: 332339.

TangJ, ChenL, WhitePF, et al. Recovery profile, costs, and patient satisfaction with propofol and sevoflurane for fast-track office-based anesthesia.Anesthesiology1999; 91: 253261.

HaleyS, EdelistG, UrbachG. Comparison of alfentanil, fentanyl and enflurane as supplements to general anaesthesia for outpatient gynaecologic surgery.Can J Anaesth1988; 35: 570575.

CartwrightDP, KvalsvikO, CassutoJ, et al. A randomized, blind comparison of remifentanil and alfentanil during anesthesia for outpatient surgery.Anesth Analg1997; 85: 10141019.

SukhaniR, VazquezJ, PappasAL, et al. Recovery after propofol with and without intraoperative fentanyl in patients undergoing ambulatory gynecologic laparoscopy.Anesth Analg1996; 83: 975981.

HoughMB, SweeneyB. Postoperative nausea and vomiting in arthroscopic day-case surgery: a comparison between desflurane and isoflurane.Anaesthesia1998; 53: 910924.

TraceyJA, HollandAJC, UngerL. Morbidity in minor gynaecological surgery: a comparison of halothane, enflurane and isoflurane.Br J Anaesth1982; 54: 12131215.

GunawardeneRD, WhiteDC. Propofol and emesis.Anaesthesia1988; 43(Suppl): 6567.

NathanN, PeclitA, LahrimiA, FeissP. Comparison of sevoflurane and propofol for ambulatory anaesthesia in gynaecological surgery.Can J Anaesth1998; 45: 11481150.

FeltsJA, PolerSM, SpitznagelEL. Nitrous oxide, nausea, and vomiting after outpatient gynecologic surgery.J Clin Anesth1990; 2: 168171.

HovorkaJ, KorttilaK, ErkolaO. Nitrous oxide does not increase nausea and vomiting following gynaecological laparoscopy.Can J Anaesth1989; 36: 145148.

PowerKJ. Anesthesia for day case oral surgery.Br J Oral Maxillofac Surg1989; 27: 387393.

DivatiaJV, VaidyaJS, BadweRA, HawaldarRW. Omission of nitrous oxide during anesthesia reduces the incidence of postoperative nausea and vomiting.Anesthesiology1996; 85: 10551062.

EbertTJ, RobinsonBJ, UhrichTD, MackenthunA, PichottaPJ. Recovery from sevoflurane anesthesia.Anesthesiology1998; 89: 15241531.

JooHS, PerksWJ. Sevoflurane versus propofol for anesthetic induction: a meta-analysis.Anesth Analg2000; 91: 213219.

SneydJR, CarrA, ByromWD, BilskiAJT. A meta-analysis of nausea and vomiting following maintenance of anaesthesia with propofol or inhalational agents.Eur J Anaesthesiol1998; 15: 433445.

TramèrM, MooreA, McQuayH. Omitting nitrous oxide in general anaesthesia; meta-analysis of intraoperative awareness and postoperative emesis in randomized controlled trials.Br J Anaesth1996; 76: 186193.

TramèrM, MooreA, McQuayH. Propofol anaesthesia and postoperative nausea and vomiting: quantitative systematic review of randomized controlled studies.Br J Anaesth1997; 78: 247255.

TramèrM, MooreA, McQuayH. Meta-analytic comparison of prophylactic antiemetic efficacy for postoperative nausea and vomiting: propofol anaesthesia vs omitting nitrous oxide vs total i.v. anaesthesia with propofol.Br J Anaesth1997; 78: 256259.

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European Journal of Anaesthesiology
  • ISSN: 0265-0215
  • EISSN: 1365-2346
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