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Low-Flow Desflurane vs Sevoflurane: Impact on Physiology and Recoveryand Recovery Profiles in Adult ENT Surgery

Not Applicable
Recruiting
Conditions
Anesthesia, General
Interventions
Registration Number
NCT07016308
Lead Sponsor
Harran University
Brief Summary

This randomized, double-blind, controlled clinical trial aims to compare the effects of low-flow sevoflurane and desflurane anesthesia on physiological parameters and recovery profiles in adult patients undergoing ENT surgeries. The primary outcomes include heart rate, mean arterial pressure, peripheral oxygen saturation, end-tidal CO₂, and arterial blood gas values. Secondary outcomes involve time to spontaneous respiration, extubation, and response to verbal commands.

Detailed Description

This prospective study investigates the clinical effects of low-flow anesthesia using two commonly utilized volatile agents, sevoflurane and desflurane, in adult patients undergoing elective ENT surgeries, specifically rhinoplasty, mastoidectomy, and tympanoplasty. A total of 40 ASA I-II patients, aged 18-65, will be randomly assigned into two groups: Group S (sevoflurane) and Group D (desflurane).

All participants will undergo general anesthesia with endotracheal intubation. After 2 minutes of preoxygenation with 100% oxygen at 10 L/min, anesthesia will be induced and maintained with the assigned volatile agent under low-flow settings (1 L/min, 50% O₂-50% air). Hemodynamic and respiratory parameters (HR, MAP, SpO₂, EtCO₂) will be recorded at predefined time points, along with arterial blood gas analysis (pH, pCO₂, pO₂, COHb).

Recovery times including return of spontaneous respiration, extubation, and verbal response will be documented. This study aims to provide clinical evidence on the optimal anesthetic choice under low-flow conditions, supporting safer, more efficient, and environmentally conscious anesthesia practices.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Adults aged between 18 and 65 years
  • Classified as ASA physical status I or II
  • Scheduled to undergo elective ENT surgery (rhinoplasty, mastoidectomy, or tympanoplasty)
  • Requiring general anesthesia with endotracheal intubation
  • Providing written informed consent
Exclusion Criteria
  • ASA physical status III or higher
  • History of malignant hyperthermia or delayed emergence from anesthesia
  • Morbid obesity (BMI ≥ 35)
  • Coronary artery disease, congestive heart failure, COPD, liver or kidney disease
  • Pregnancy or breastfeeding
  • Allergy to halogenated anesthetics
  • Respiratory pathology
  • Substance or alcohol abuse

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Sevoflurane Low-Flow AnesthesiaSevofluraneParticipants in this group will receive general anesthesia using sevoflurane administered under low-flow conditions. After standard induction and intubation, sevoflurane will be maintained at 2-3% (0.8-1 MAC) with a fresh gas flow of 1 L/min (50% oxygen / 50% air). Vital signs and arterial blood gases will be monitored, and recovery parameters such as time to spontaneous breathing, extubation, and verbal response will be recorded.
Sevoflurane Low-Flow AnesthesiaDesfluraneParticipants in this group will receive general anesthesia using sevoflurane administered under low-flow conditions. After standard induction and intubation, sevoflurane will be maintained at 2-3% (0.8-1 MAC) with a fresh gas flow of 1 L/min (50% oxygen / 50% air). Vital signs and arterial blood gases will be monitored, and recovery parameters such as time to spontaneous breathing, extubation, and verbal response will be recorded.
Desflurane Low-Flow AnesthesiaSevofluraneParticipants in this group will receive general anesthesia using desflurane administered under low-flow conditions. After standard induction and intubation, desflurane will be maintained at 4-6% (0.8-1 MAC) with a fresh gas flow of 1 L/min (50% oxygen / 50% air). Hemodynamic and respiratory parameters as well as arterial blood gases and recovery times will be evaluated and compared to the sevoflurane group.
Desflurane Low-Flow AnesthesiaDesfluraneParticipants in this group will receive general anesthesia using desflurane administered under low-flow conditions. After standard induction and intubation, desflurane will be maintained at 4-6% (0.8-1 MAC) with a fresh gas flow of 1 L/min (50% oxygen / 50% air). Hemodynamic and respiratory parameters as well as arterial blood gases and recovery times will be evaluated and compared to the sevoflurane group.
Primary Outcome Measures
NameTimeMethod
Change in Heart Rate During SurgeryFrom preoperative baseline to 120 minutes after anesthesia induction

Heart rate (HR) will be measured at baseline, post-intubation, and at 15, 30, 45, 60, and 120 minutes after anesthesia induction.

Change in Mean Arterial Pressure During SurgeryFrom preoperative baseline to 120 minutes after induction

Mean arterial pressure (MAP) will be recorded at the same predefined time intervals during surgery.

Change in End-Tidal CO₂From preoperative baseline to 120 minutes after induction

End-tidal carbon dioxide (EtCO₂) levels will be monitored during surgery at specified intervals.

Change in Peripheral Oxygen SaturationFrom preoperative baseline to 120 minutes after induction

Peripheral oxygen saturation (SpO₂) will be measured at baseline, post-intubation, and intraoperative time points.

Secondary Outcome Measures
NameTimeMethod
Change in Arterial pHPreoperative, intraoperative (60 and 120 min), end of surgery

Arterial blood gas samples will be analyzed for pH at baseline, 60 and 120 minutes, and at end of surgery.

Post-Anesthesia Recovery TimesFrom end of surgery until recovery (within approx. 30 minutes)

Time to return of spontaneous respiration, time to extubation, and time to follow verbal commands will be recorded.

Trial Locations

Locations (1)

Veli Fahri Pehlivan

🇹🇷

Şanlıurfa, Turkey

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