Anesthesia; Adverse Effect, Laryngeal Masks, Respiratory System Abnormalities
Conditions
Keywords
Desflurane, Sevoflurane, Respiratory Complications
Brief summary
The effects of desflurane versus sevoflurane in adult patients undergoing LMA anesthesia on respiratory events during a less than 2-hour elective surgery.
Detailed description
Laryngeal Mask Airway (LMA) anesthesia is generally performed for ambulatory surgery to avoid the use of neuromuscular blocking agents and to facilitate rapid emergence from anesthesia. Inhaled anesthetics are simply and popularly used during maintenance of anesthesia. The two most recent volatile anesthetic agents, desflurane and sevoflurane, are the two most commonly used in clinical practice for an ambulatory setting. Desflurane is the volatile agent with low blood: gas partition coefficient (0.42). Desflurane's uptake and elimination from the body of a patient are rapid, which results in a fast onset of anesthesia and a fast recovery from anesthesia. This property provides desflurane as an ideal agent for the ambulatory anesthesia. However, its pungent odor is concerned to irritate the upper airway and may cause significant respiratory complications. Sevoflurane has a blood: gas partition coefficient of 0.65, which is slightly greater than desflurane. The major advantage over desflurane is the better scent. It is considered to be less airway irritation in LMA anesthesia with smooth induction and recovery. The limitation of desflurane on its odor leads to a controversy if desflurane is similar to or worse than sevoflurane for LMA anesthesia. This is non-inferiority study designed to compare the occurrence of respiratory complications between desflurane and sevoflurane during LMA anesthesia.
Interventions
DRUGDesflurane
Desflurane is the volatile agent with low blood: gas partition coefficient (0.42), its uptake and elimination from the body of a patient are rapid, which results in a fast onset of anesthesia and a fast recovery from anesthesia. This property provides desflurane as an ideal agent for the ambulatory anesthesia. However, its pungent odor is concerned to irritate the upper airway and may cause significant respiratory complications.
DRUGSevoflurane
Sevoflurane has a blood: gas partition coefficient of 0.65, which is slightly greater than desflurane. The major advantage over desflurane is the better scented. It is considered to be less airway irritation in LMA anesthesia with smooth induction and recovery.
Sponsors
Chiang Mai University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Patients with American Society of Anesthesiologists physical status classification of I-III * Elective surgery * Surgery with expected duration of operation of less than 2 hours * Surgery that anesthesiologist plans to use laryngeal mask airway during anesthesia
Exclusion criteria
* Patients with gastroesophageal reflux disease * Patients with hiatal hernia * Patients with history of upper respiratory tract infection within 1 month before surgery * Heavy smoker (\> 20 cigarettes per day) * Obese patients with body mass index \> 30kg/m2 * Pregnant patients * Unable to provide a written informed consent patients * Surgery requiring non-depolarizing muscle relaxants
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Occurrence of respiratory complications | From the beginning of operation until 30 minutes after the operation | Respiratory complications are coughing, breath holding, laryngospasm, bronchospasm, and desaturation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time of eye opening | Within 30 minutes after the end of operation | It is the time from discontinuation of anesthetic to the eye opening on verbal command. |
| Time to follow motor command | Within 30 minutes after the end of operation | It is the time from discontinuation of anesthetic to hand squeezing. |
| Time of LMA removal | Within 30 minutes after the end of operation | It is the time from discontinuation of anesthetic to removal of LMA. |
| Changes of blood pressure during anesthesia | Every 15 minutes, from the beginning of operation until 30 minutes after the operation | Non-invasive blood pressure will be recorded at the beginning of anesthesia, every 15 minutes during anesthetic maintenance, and at the time of LMA removal. |
| Changes of heart rate during anesthesia | Every 15 minutes, from the beginning of operation until 30 minutes after the operation | Heart rate will be recorded at the beginning of anesthesia, every 15 minutes during anesthetic maintenance, and at the time of LMA removal. |
| Frequency of postoperative nausea and vomiting (PONV) | Within 2 hours after operation | It is a number of patients with PONV in the early post-anesthetic period. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Time to achieve a satisfied Modified Aldrete score | Within 2 hours after operation | It is the time that the patient is ready to be discharged from post-anesthetic care unit. |
| Number of Patients with high satisfaction to anesthesia | At 12-24 hour after surgery | The satisfaction is graded using a 5-point rating scale. |
Countries
Thailand
Contacts
Primary ContactPathomporn Pin-on, M.D.
Backup ContactPrangmalee Leurcharusmee, M.D.
Outcome results
None listed