Bispectral monitoring anesthesia with remifentanil-desflurane has a better post-operative recovery than remifentanil-propofol.

It is a randomized, double blind study, involving 40 adult female patients submitted to general anesthesia. The patients were distributed into 2 groups: remifentanil-propofol-based anesthesia and remifentanil-desflurane-based anesthesia groups. Bispectral index (BIS) monitoring guided the anesthesia by setting target BIS range value between 40 and 60. Anesthetics were adjusted to reached that. Primary outcome was: extubation time (time from anesthetic discontinuation to endotracheal tube cuff). Secondary measured outcomes: intra-operative cardiovascular drug use; time to follow command before extubation; protective airway reflex recovery time after extubation. Protective airway reflex test recovery was performed at predetermined time intervals (2, 6, 14, 22 and 30 minutes) from the time to follow a standard command until the first demonstrated ability to swallow 20 ml of water in an upright position.Post-anesthesia care unit recovery data were also recorded: Ramsay sedation scale; vital signs, post-operative pain; morphine consumption.

Inclusion Criteria:

• Female patients over 18 years old classified by the American Society of Anesthesiologists as physical status I or II, undergoing elective breast surgery with general anesthesia.

Exclusion Criteria:

• History of: illegal drug and alcohol abuse
• Pregnancy on course or suspicion of
• Neuromuscular disorders
• Cerebral vascular disease
• Dysphagia
• Dysphonia
• Gastroesophageal reflux disease
• Previous larynx and/or upper gastrointestinal tract surgery
• Allergy to any drug to be used and malignant hyperthermia.
• Patients who develop hemodynamic instability in the surgery and need blood transfusion were excluded from the study.
• Patients unable to swallow 20 ml of water in an upright position were also excluded.