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

Study Overview
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Brief Summary
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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: 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 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.

Official Title
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A Comparison of Desflurane vs. Sevoflurane on Time to Awakening and the Incidence and Severity of Cough After Ambulatory Surgery Using Laryngeal Mask Airway

Conditions
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Surgery, Anesthesia

Intervention / Treatment
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* Drug: Desflurane
* Drug: Administration of Sevoflurane


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Desflurane<br>Administration of Desflurane | Drug: Desflurane<br>* Administratino of Desflurane<br>|
| Active Comparator: Sevoflurane<br>Administration of Sevoflurane | Drug: Administration of Sevoflurane<br>* Administration of Sevoflurane<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to Awakening |  | Time inhalational agent is turned off to time of patient awakening | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants Who Coughed |  | Perioperative | 
| Quality of Recovery 40 | 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. | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Induction, Coughing, Anesthesia