Standard Anesthetic Technique for Middle Ear Surgical Procedures: A Comparison of Desflurane and Sevoflurane

This study was designed to compare desflurane and sevoflurane anesthesia for middle ear microsurgery. One hundred healthy adults undergoing middle ear surgery were assigned to receive either desflurane or sevoflurane as their anesthetic. Intraoperative hemodynamics and BIS numbers were recorded. Hemodynamics, pain, nausea/vomiting, discharge readiness, and other parameters were compared postoperatively and 24 hours later. No intraoperative differences were noted except in BIS scores which trended lower with desflurane. PACU blood pressures were higher after desflurane but pain scores, nausea/vomiting, rescue anti-emetics, recovery scores, and discharge times were similar. A significant difference was noted in anesthetic costs (desflurane > sevoflurane), and in patients with the lowest BIS scores associated with more nausea/vomiting. Both anesthetics may be used for ototic surgery but propofol anesthesia should still be considered in patients with a history of emetic sequelae. Short-acting inhalational anesthetics produce excellent operating conditions and reduce costs for otologic surgery.