Anesthesıa the effect of desflurane, sevoflurane and ısoflurane on mıddle ear pressure and post-operatıve nausea and vomıtıng

In this study we aimed to measure the effect of mostly used anesthetic agents desflurane, sevoflurane and isoflurane on middle ear pressure and post operative nausea and vomiting frequency.Sixty patients scheduled for elective laparoscopic cholecystectomy in ASA I-II risk groups, were involved into the study. Both ears of the patients were examined with otoscope before operation. The patients were randomly divided into three groups: desflurane (group D, n:20), sevoflurane (group S, n:20) and isoflurane (group I, n:20).In all the three groups, anesthesia induction was performed with 5-7 mg kg-1 thiopental sodium and 0.2 µg kg-1 dk-1 remifentanyl. Endotracheal intubation was performed three minutes after injection of 0.6 mg kg-1 rocuronium bromide,. The ventilation of patients was adjusted by 40% oxygen/air mixture of 4 L min-1, 12 min-1 frequency and a tidal volume of 8 mL kg-1. As an inhalation anesthesia desflurane, sevoflurane and isoflurane (at level of 1 MAC) were used.Heart rate, systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, right middle ear pressure, left middle ear pressure were measured in every three minutes before and after induction anesthesia and 9 minutes after intubation; in every five minutes till half an hour of the induction anesthesia and the latter measurements were done in every fifteen minutes. EtCO2 was measured simultaneously with the other parameters after the patient was intubated. Right middle ear pressure, left middle ear pressure, verbal descriptive scale and the dosage of injected metoclopramid were recorded at 5th, 15th and 30th minutes, postoperatively. The time and total dosage of metoclopramid injected in 24 hours postoperatively was also recorded.In conclusion, among the anesthetic agents used in this study, desflurane caused increment in middle ear pressure levels. Postoperative nausea and vomiting occurred mostly with desflurane anesthesia. There was no association between middle ear pressure and postoperative nausea and vomiting.