Volatile Anesthetic Choice and Duration of Hospitalization: A Quality Improvement and Cost-control Project

Study Overview
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Brief Summary
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Preliminary retrospective data suggest that the relatively soluble but inexpensive volatile anesthesia isoflurane prolongs the duration of hospitalization compared to the less soluble but more expensive anesthetic sevoflurane. Even a small reduction in the duration of hospitalization would easily compensate for the modest additional cost of sevoflurane. The investigators therefore propose to test the primary hypothesis that duration of hospitalization is longer with isoflurane than sevoflurane. The investigators will also test the secondary hypotheses that: 1) pain scores are greater in patients recovering from isoflurane than sevoflurane anesthesia; and, 2) opioid consumption is greater after isoflurane than sevoflurane anesthesia. All statistical analyses will be adjusted for age, gender, race, baseline risk, 9 and procedure.

Official Title
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Volatile Anesthetic Choice and Duration of Hospitalization: A Quality Improvement and Cost-control Project

Conditions
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Duration of Hospitalization

Intervention / Treatment
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* Drug: Isoflurane
* Drug: Sevoflurane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must have surgery in G operating room suite
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

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Isoflurane<br>Isoflurane is to be administered to patients in this arm during surgery | Drug: Isoflurane<br>* Isoflurane is administered to patient during surgery as it would normally be administered by the attending anesthesiologist<br>|
| Experimental: Sevoflurane<br>Sevoflurane is to be administered to patients in this arm during surgery | Drug: Sevoflurane<br>* Sevoflurane is administered to patient during surgery as it would normally be administered by the attending anesthesiologist<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hospital Length of Stay |  | participants will be followed for the duration of hospital stay, an expected average of 3 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time-weighted Average Verbal Rating Pain Score | Time-weighted average VRS (Verbal Rating Scale) pain score over the first 72 h after surgery as recorded by nurses at approximately 4-h intervals. The VRS pain score is from 0 (no pain) to 10 (worst imaginable pain). | up to 72 hours after surgery | 
| Total Intraoperative Opioid Consumption | Total amount of opioid in IV morphine equivalents used during surgeyr | intraoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sevoflurane, Isoflurane, volatile anesthetic, duration of hospitalization