Desflurane Versus Isoflurane for Speeding Postanesthetic Recovery and Hospital Discharge
- Registration Number
- NCT06252207
- Lead Sponsor
- The Cleveland Clinic
- Brief Summary
The investigators thus propose a comparative effectiveness quality improvement project to evaluate the feasibility of switching from near-exclusive use of isoflurane in adult general surgical patients to Desflurane.
- Detailed Description
The three available volatile anesthetics appear to be comparably safe. However, higher solubility slows emergence from isoflurane and sevoflurane compared to Desflurane. Even a few minutes delay in emergence from anesthesia has financial implications since institutional costs of operating room time can easily be $30 per minute. Postoperative care is also expensive. Furthermore, in busy hospitals such as the Cleveland Clinic, inadequate recovery throughput frequently delays surgery.
The investigators thus propose a comparative effectiveness quality improvement project to evaluate the feasibility of switching from near-exclusive use of isoflurane in adult general surgical patients to Desflurane. (The investigators will exclude children because there are compelling clinical reasons to use sevoflurane in pediatric patients.) The proposed comparison is between isoflurane (our current routine) and Desflurane which is no longer used at the Clinic because of price concerns - a decision that that did not consider down-stream effects, including prolonged emergence and recovery.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 2619
- Adults having general anesthesia in the G operating room suite at the Cleveland Clinic Main Campus.
- Operations lasting <1.5 hours.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Isoflurane Isoflurane General anesthesia with isoflurane. Desflurane Desflurane General anesthesia with desflurane.
- Primary Outcome Measures
Name Time Method Duration of post-anesthesia care unit recovery 1 hour Time from entry to the post-anesthesia to discharge from unit.
- Secondary Outcome Measures
Name Time Method Duration of anesthetic emergence 1 hour Time from a MAC fraction of 0.3 (presumably shortly after volatile anesthesia is discontinued) and extubation.
Cost of post-anesthesia care unit. 2 hours Cost of post-anesthesia unit care. To be estimated only if there is a substantial difference between the groups.
Delirium 5 days Incidence of postoperative delirium.