Background: Rapid emergence from general anaesthesia with early recovery of cognitive function is crucial for improved postoperative outcomes, patient satisfaction, and operating room efficiency. Volatile anaesthetic agents such as desflurane and sevoflurane differ in their pharmacokinetic properties, which may influence emergence characteristics and early cognitive recovery. Understanding these differences is particularly important in the context of enhanced recovery protocols and ambulatory surgeries. Aim: To compare emergence characteristics and early postoperative cognitive recovery in adult patients undergoing general anaesthesia with desflurane versus sevoflurane. Methods: This prospective randomized comparative study was conducted in the Department of Anaesthesiology at Sree Mookambika Institute of Medical Sciences. Ninety-two patients aged 18–50 years, classified as ASA physical status I and II, undergoing elective surgeries of 2–3 hours duration were included. Patients were randomly allocated into two groups: Group A received sevoflurane and Group B received desflurane for maintenance of anaesthesia at 1 MAC. Standardized anaesthetic techniques were followed in both groups. Emergence parameters including time to spontaneous breathing, response to pain, extubation, and cognitive recovery were recorded. Early cognitive function was assessed using the Digit Symbol Substitution Test (DSST), and recovery was evaluated using the Modified Aldrete Score (MAS). Results: Demographic variables and duration of surgery were comparable between the two groups (p > 0.05). Hemodynamic parameters remained stable with no significant differences. The requirement for additional fentanyl was significantly higher in the desflurane group (p < 0.001). Emergence and recovery times were significantly shorter in the desflurane group, including time to spontaneous breathing, response to pain, extubation, and recall of personal information (p < 0.001). Neuromuscular recovery and achievement of adequate recovery scores (MAS > 9) were also faster with desflurane. Cognitive recovery, assessed by DSST, occurred earlier in the desflurane group compared to sevoflurane (p < 0.001). Conclusion: Both desflurane and sevoflurane provide stable intraoperative hemodynamics; however, desflurane offers significantly faster emergence, early recovery, and cognitive function. Despite a higher requirement for supplemental opioids, desflurane may be preferred in clinical scenarios where rapid recovery is desired.

Desflurane, Sevoflurane, Emergence, Cognitive recovery, DSST, General anaesthesia