Comparative evaluation of sevoflurane and desflurane for intraoperative brain condition, hemodynamics and postoperative recovery in patients undergoing supratentorial craniotomy

Inhaled volatile anaesthetics remain the most widely accepted drugs for maintenance of general anaesthesia in neurosurgical operations due to their ease of administration, the availability of end-tidal agent monitoring, and predictable intra-operative and recovery characteristics. A new dimension had been added to recovery from anaesthetics especially after the introduction of less soluble inhalational anaesthetics, sevoflurane and desflurane.Sevoflurane with prolonged administration, recovery times may be delayed and this benefit would be lost.Desflurane is a volatile anaesthetic known to have early recovery from anaesthesia due to its low blood solubility and low blood-gas (0.42) and tissue-blood partition coefficients resulting in a more rapid wash in and wash out in comparison to the other known volatile anaesthetics.However, there was much debate on its use in neurosurgery because it possesses a vasodilator effect on cerebral blood vessels. However, no variation in intracranial pressure (ICP) in normocapnic patients undergoing removal of supratentorial tumors using desflurane anesthesia was demonstrated.