A Randomized Study to Compare the Recovery Profile among the Surgical Patients Undergoing General Anesthesia with Sevoflurane and Desflurane in a Cancer Center in Oman

Abstract Introduction: A randomized study was done to assess the recovery characteristics of patients undergoing onco-surgical procedures under GA with either sevoflurane or desflurane. Methods: The study was approved by the ethics committee of SQCCCRC, and the study was conducted from 01 Jan 2024 to 31 Dec 2024. 120 patients undergoing onco-surgical procedures were randomly allocated into two groups: D (Desflurane) and S (Sevoflurane). Keeping the primary aim of the study of early recovery from volatile anesthesia, the power of the study at 80% and confidence limit at 95%, the minimum sample size was calculated by using the formula ( n =(Zα/2+Zβ)2*(p1(1-p1) +p2(1-p2))/(p1-p2)2) came around 60 in each group. Descriptive statistics (mean, median, standard deviation) were used for demographic and outcome variables. Comparative analysis using independent t -tests (for normally distributed continuous data) or Mann-Whitney U tests (for non-parametric data) was used to compare the outcome measures between the two groups. Continuous data (for Qor15) were inspected for normality before analysis was done by the Shapiro-Wilk test. Results: The early recovery parameters in Group D vs Group S were found statistically significant in the Desflurane group ((time to swallowing 3.98 ± 1.1 vs. 6.12 ± 0.9, time for spontaneous eye opening 3.93 ± 0.66 vs. 5.13 ± 1.2, time to respond to verbal command 4.38 ± 1.12 vs. 6.17 ± 1.1, time to establish regular breathing pattern 4.48 ± 1.12 vs. 6.17 ± 1.1, time to tracheal extubation 7.97 ± 1.03 vs. 8.1 ± 1.15), the time to reach Aldrete score of 9 (7.91 ± 1.37 vs. 9.67 ± 2.18). The overall median preoperative QoR 15 score was 116±17, while the postoperative overall scores in the Desflurane group were 95±2 and in the sevoflurane group were 91±3. The average environmental impact of desflurane was 25.6 kg of CO 2 equivalent per case, and for sevoflurane, it was 0.72 kg of CO 2 equivalent per case. Conclusion: Desflurane offers expedited recovery in onco-surgical patients, but its high cost and environmental burden challenge its routine use. Sevoflurane emerges as a balanced choice for institutions prioritizing sustainability and cost-efficiency.