Ventilatory Effect on Speed of Anesthesia Under Various Inhaled Anesthetics
Condition: Pharmacokinetics of Inhaled Anesthetics
MeSH terms: Respiratory Aspiration
Study type: Interventional

Summary: 
      Three groups of patients are going to have minor surgery under general anesthesia with
      inhaled anesthetics and different ventilatory setting (Tidal volume: 8, 10, 12 ml/kg,
      respiratory rate: 10/min each). Group A (Sevoflurane) will use sevoflurane, group B
      (Desflurane) will use desflurane, and group C (Isoflurane) will use isoflurane. It will be
      observed differences among the groups for ventilatory effects on speed of induction.

      Duration of this randomised controlled trial will be about 3 months. Estimated sample size
      will be 36 patients(12 in each group).
    

Detailed description: 
      No premedicant will be given. The anesthetic workstation and a circulatory circuit will be
      prefilled with 1.0 MAC of inhaled anesthetic that will be selected randomly.

        -  Group A (n=12): Sevoflurane 2.0 vol%

        -  Group B (n=12): Desflurane 6.0 vol%

        -  Group C (n=12): Isoflurane 1.2 vol%

      Each group has 3 subgroups according to the ventilatory setting that will also be randomly
      determined.

        -  Hypoventilation: tidal volume 8 ml/kg, respiratory rate 10 /min

        -  Normoventilation: tidal volume 10 ml/kg, respiratory rate 10 /min

        -  Hyperventilation: tidal volume 12 ml/kg, respiratory rate 10 /min

      Patients will be preoxygenated with 100% oxygen (5 L/min) for 5 minutes under pulse oximeter,
      EKG, and noninvasive blood pressure monitoring. Bispectral index (BIS) monitor will be
      applied.

      The induction of general anesthesia will start with propofol (2 mg/kg), rocuronium (0.8
      mg/kg) and remifentanil infusion (0.1 mcg/kg/min). The size of a tracheal tube will be 7.5 mm
      (ID) for male, 7.0 mm (ID) for female. After intubation, anesthesia workstation will be
      connected to the tracheal tube. Ventilation will start, and that point will be time 0. During
      720 seconds, inspiratory (PIgas) and end-tidal concentration of inhaled anesthetics (ETgas),
      end-tidal partial pressure of carbon dioxide, and BIS will be measured at time 0, 30, 60, 90,
      120 ,150, 180, 240, 300, 360, 480, 600, and 720 seconds. Mean blood pressure and heart rate
      will also be recorded every 2 minutes. Fresh gas flow will be kept at 6 L/min with 100%
      oxygen.

      The fraction of ETgas/PIgas will be analyzed with nonlinear mixed effects modeling.

      Estimated sample size will be 36 patients (12 in each group, 4 in each ventilatory settings).
    

Intervention name(s): Sevoflurane; Desflurane; Isoflurane
Intervention type(s): Drug; Drug; Drug
Intervention description(s): 2.0 vol% prefilled in a corrugated circuit.; 6.0 vol% prefilled in a corrugated circuit.; 1.2 vol% prefilled in a corrugated circuit.
Other intervention name(s): Sevorane; Suprane; Aerane
Intervention MeSH terms: Sevoflurane; Desflurane; Isoflurane
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Basic Science
Keywords: Anesthetic induction; Desflurane; Isoflurane; Sevoflurane; Ventilation