Sevoflurane and desflurane are the most frequently used volatile anaesthetic agents. This single‐centre cohort study provides a direct comparison of the 2 most commonly used anaesthetics concerning important safety outcome and postoperative respiratory complications. And, hence desflurane for maintaining general anaesthesia did not decrease the risk of respiratory complications after the operation.

This study aimed to evaluate the association between choice of volatile anaesthetic and initial postoperative respiratory complications and focused on a significant knowledge gap in safety outcomes between these 2 commonly used agents.

A retrospective analysis of non‐cardiac surgery patients who got sevoflurane or desflurane for general anaesthesia maintenance was performed. The link between desflurane exposure (when contrasted with sevoflurane) and the primary outcome of respiratory complications after the operation, expressed as initial post‐extubation desaturation (SpO2 < 90%) or re‐intubation in 7 days was evaluated.

The multivariable regression analyses were used as per confounding factors, like patient, anaesthetic and surgical factors. Obesity (BMI > 35 kg.m−2); old age of more than 65 years; and high risk of respiratory complications along with primary outcome at 24 hours were assessed via propensity-matched, interaction and sub‐group analyses.

Desflurane and sevoflurane were used for 23,830 and 84,608 patients, respectively. As compared to sevoflurane, the patients exposed to desflurane did not demonstrate a reduced risk of postoperative respiratory complications (Table 1).

All sub‐groups of high‐risk patients and propensity score matched cohort had steady findings.

The use of desflurane use was not linked with decreased postoperative respiratory complications than with sevoflurane. This study provides significant data to support organisational decisions concerning desflurane use in terms of environmental and cost distresses with volatile anaesthetic agents.