Doxapram shortens recovery following sevoflurane anesthesia

Purpose: A randomized, double blind controlled trial was undertaken to investigate the effect of doxapram on recovery times and bispectral index following sevoflurane anesthesia. Methods: Upon completion of surgery under sevoflurane anesthesia, 60 adult patients were randomly allocated to receive either doxapram hydrochloride 1 mg·kg^-1 iv or saline placebo. Clinical recovery from anesthesia was assessed by time to eye opening on verbal command, hand squeezing on command, time to extubation, and the Aldrete recovery score. Bispectral index values, systolic blood pressure, and heart rate were recorded at baseline (before anesthesia), during surgery, and every minute for 15 min after administration of the study drug. Results: Time to eye opening was shorter in the doxapram group compared with the control group (6.9 ± 2.2 min vs 9.9 ± 3.1 min, P <0.05). Mean bispectral index scores were also higher in the doxapram group compared with the saline placebo seven to eight minutes following administration of the study medication (P <0.05). More rapid emergence was associated with a greater increase in heart rate with doxapram (P <0.05 compared with placebo), but no differences in systolic blood pressure responses were observed in comparison with placebo. Conclusion: We conclude that doxapram 1 mg·kg^-1 hastens early recovery from sevoflurane anesthesia, and this arousal effect correlates with higher bispectral index values.