The effect of sevoflurane, desflurane and propofol on respiratory mechanics and integrated pulmonary index scores in laparoscopic sleeve gastrectomy: A randomized trial

OBJECTIVES: To compare the effects of sevoflurane, desflurane, and propofol on respiratory mechanics, and integrated pulmonary index (IPI) scores in patients undergoing laparoscopic sleeve gastrectomy. METHODS: A total of 60 patients with a body mass index of ≥40 kg/m(2), who underwent laparoscopic sleeve gastrectomy between September 2015 and September 2016 at Fatih Sultan Mehmet Health Application and Research Center, Istanbul, Turkey were included in this randomized prospective study. After induction, anesthesia was maintained by sevoflurane in group S, desflurane in group D, and propofol in group P. Peak inspiratory pressure (PIP), plateau pressure (P(plateau)), compliance (Cdyn), respiratory resistance (Rrs), and IPI values were recorded. Mann-Whitney U, Kruskal-Wallis, Dunn’s, Friedman, and Fisher-Freeman-Halton tests were performed for statistical analysis. A p value of <0.05 was considered statistically significant. RESULTS: A significant increase was found in PIP in group S (T(1): 25; T(2): 27 cmH(2)O), and group D (T(1): 25; T(2): 29,5 cmH(2)O) during pneumoperitoneum. Dynamic compliance decreased in all groups during pneumoperitoneum. In group S, the decrease in Cdyn was also statistically significant after pneumoperitoneum (T(1): 43.65; T(5): 41.25 ml/cmH(2)O). Comparison between groups the values of PIP, P(plateau), Cdyn, Rrs, and IPI were similar. CONCLUSION: In morbidly obese patients, sevoflurane, desflurane, and propofol are similar in terms of the intraoperative respiratory mechanics, and perioperative respiratory parameters provided with IPI.