which is better, sevoflurane or desflurane?
A. Casati1, G. Torri1 and L. De Baerdemaeker2 1 Milan, Italy 2 Gent, Belgium Editor We read with interest the manuscript by De Baerdemaeker and colleagues1 on the optimization of desflurane and sevoflurane administration in morbidly obese patients by using an inhalation bolus technique. The authors must be complimented for developing this interesting technique in the obese population; however, there are two points that deserve comment. We agree with the authors that using BIS-guided administration of the volatile anaesthetic can overcome the problem of under- or overdosing, as reported when the level of anaesthesia is titrated only on the value of MAC.2 However, when giving the bolus of the volatile agent to patients in the sevoflurane group, the inspired concentration of the volatile anaesthetic was increased up to a value >4 MAC, while in patients anaesthetized with desflurane the inspired concentration was increased only up to 2.5 MAC.3 As one of the main aims of the study was evalu
