A Comparison of Desflurane vs. Sevoflurane and the Time to Awakening and the Incidence and Severity of Cough

NCT01202162 | Completed Results

• 1 other identifier: STU00036200
• Study Type: interventional
• Target: 85
• Locations: 1 country
• Sites: 1

Brief Summary

Goals for ambulatory surgery include providing optimal surgical conditions while ensuring a rapid early recovery without side effect. Dexter et al1 concluded in a meta-analysis that Desflurane can reduce the extubation time when compared to Sevoflurane. This potential benefit of Desflurane can be especially attractive in short ambulatory cases performed with general anesthesia with a laryngeal mask airway. Although some studies have not shown a difference on perioperative cough and laryngospasm between Desflurane and Sevoflurane at clinically relevant doses.It has been reported in the literature that Desflurane causes cough4 and many providers avoid using Desflurane with a LMA (laryngeal mask airway) in the ambulatory setting. In this study we will also evaluate, as a secondary outcome, the presence and severity of perioperative cough and laryngospasm. Previous investigators have demonstrated a more rapid resumption of normal daily activities after ambulatory surgery in patients anesthetized with Desflurane when compared with Sevoflurane.these investigators suggested a better quality of recovery when Desflurane is used probably due to a lower lipid solubility of Desflurane. We will also evaluate quality of recovery as a secondary outcome using a validated instrument. Significance:

1. 1.A more rapid awakening, especially, in a fast and high turnover cases that are performed with LMA can lead to a more cost effective utilization of operating room time
2. 2.It has been reported that Desflurane causes more cough than Sevoflurane and Anesthesiologists avoid using Desflurane with LMA cases, this study will reinforce that there is no difference.

Conditions

Surgery; Anesthesia

Keywords

Induction; Coughing; Anesthesia

Outcome Measures

Primary Outcomes (1)

• Time to Awakening

  Time inhalational agent is turned off to time of patient awakening

Secondary Outcomes (2)

• Number of Participants Who Coughed

  Perioperative

• Quality of Recovery 40

  1 day

Study Arms (2)

Desflurane

ACTIVE COMPARATOR

Administration of Desflurane

Drug: Desflurane

Sevoflurane

ACTIVE COMPARATOR

Administration of Sevoflurane

Drug: Administration of Sevoflurane

Interventions

Desflurane DRUG

Administratino of Desflurane

Desflurane

Administration of Sevoflurane DRUG

Administration of Sevoflurane

Sevoflurane

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 18-65
• Female patients undergoing outpatient gynecologic and breast surgery
• Under general anesthesia using an LMA
• ASA I,II,

You may not qualify if:

• Patients on CNS depressants
• Chronic opioid use
• Corticosteroid
• Pregnant patients
• Full stomach
• Morbidly obese (BMI \>35kg/m2)
• Hepatitis B
• Hepatitis C
• Coronary artery disease
• Liver disease
• Renal disease
• Seizure disorder
• Dropout criteria:
• Need for endotracheal tube
• Surgeon or patient request

Sponsors & Collaborators

• Northwestern University: lead

Study Sites (1)

Northwestern University

Chicago, Illinois, 60611, United States

Location

Related Publications (5)

• Dexter F, Bayman EO, Epstein RH. Statistical modeling of average and variability of time to extubation for meta-analysis comparing desflurane to sevoflurane. Anesth Analg. 2010 Feb 1;110(2):570-80. doi: 10.1213/ANE.0b013e3181b5dcb7. Epub 2009 Oct 9.

  PMID: 19820242 BACKGROUND

• McKay RE, Bostrom A, Balea MC, McKay WR. Airway responses during desflurane versus sevoflurane administration via a laryngeal mask airway in smokers. Anesth Analg. 2006 Nov;103(5):1147-54. doi: 10.1213/01.ane.0000237293.39466.65.

  PMID: 17056947 BACKGROUND

• White PF, Eshima RW, Maurer A, King T, Lin BK, Heavner JE, Bogetz MS, Kaye AD. A comparison of airway responses during desflurane and sevoflurane administration via a laryngeal mask airway for maintenance of anesthesia. Anesth Analg. 2003 Mar;96(3):701-705. doi: 10.1213/01.ANE.0000048978.40522.AB.

  PMID: 12598249 BACKGROUND

• Arain SR, Shankar H, Ebert TJ. Desflurane enhances reactivity during the use of the laryngeal mask airway. Anesthesiology. 2005 Sep;103(3):495-9. doi: 10.1097/00000542-200509000-00011.

  PMID: 16129973 BACKGROUND

• Mahmoud NA, Rose DJ, Laurence AS. Desflurane or sevoflurane for gynaecological day-case anaesthesia with spontaneous respiration? Anaesthesia. 2001 Feb;56(2):171-4. doi: 10.1046/j.1365-2044.2001.01528.x.

  PMID: 11167479 BACKGROUND

MeSH Terms

Conditions

Cough

Interventions

Desflurane

Condition Hierarchy (Ancestors)

Respiration Disorders; Respiratory Tract Diseases; Signs and Symptoms, Respiratory; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Ethyl Ethers; Ethers; Organic Chemicals; Methyl Ethers; Hydrocarbons, Fluorinated; Hydrocarbons, Halogenated; Hydrocarbons

Limitations and Caveats

Our study is only valid if interpreted within the context of its limitations. We have only evaluated female subjects undergoing ambulatory hysteroscopic surgery which limits the generalizability of our results.

Results Point of Contact

• Title: Gildasio De Oliveira, M.D.
• Organization: Northwestern University

g-jr@northwestern.edu

312-926-8371

Study Officials

• Gildasio De Oliveira, M.D

  Northwestern University

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: September 13, 2010
• First Posted: September 15, 2010
• Study Start: February 1, 2010
• Primary Completion: March 1, 2012
• Study Completion: March 1, 2012
• Last Updated: November 25, 2013
• Results First Posted: July 25, 2013

Record last verified: 2013-10

Locations

US (1)