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

Not Applicable

Completed

Conditions: Surgery
Anesthesia

Interventions: Drug: Administration of Sevoflurane
Drug: Desflurane

Registration Number: NCT01202162

Lead Sponsor: Northwestern University

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. 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. 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.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 85

Inclusion Criteria

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

Exclusion Criteria

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
Hospital admission

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Sevoflurane	Administration of Sevoflurane	Administration of Sevoflurane
Desflurane	Desflurane	Administration of Desflurane

Primary Outcome Measures

Name	Time	Method
Time to Awakening	Time inhalational agent is turned off to time of patient awakening

Secondary Outcome Measures

Name	Time	Method
Number of Participants Who Coughed	Perioperative
Quality of Recovery 40	1 day	Survey completion at 24 hours post surgery of the Quality of Recovery 40 questionnaire.This questionnaire asks 40 questions in 5 categories of recovery. The scores are combined from each group and are used as a composite score. The scores range from a low of 40 to a high of 200. A score of 40 would indicate a poor quality of recovery where as a score of 200 would be a good quality of recovery at 24 hours postoperative.