Recovery Profile Comparison Between Remifentanil-propofol or Desflurane Anesthesia Monitored With Bispectral Index.

Study Overview
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Brief Summary
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Bispectral monitoring anesthesia with remifentanil-desflurane has a better post-operative recovery than remifentanil-propofol.

Detailed Description
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It is a randomized, double blind study, involving 40 adult female patients submitted to general anesthesia. The patients were distributed into 2 groups: remifentanil-propofol-based anesthesia and remifentanil-desflurane-based anesthesia groups. Bispectral index (BIS) monitoring guided the anesthesia by setting target BIS range value between 40 and 60. Anesthetics were adjusted to reached that. Primary outcome was: extubation time (time from anesthetic discontinuation to endotracheal tube cuff). Secondary measured outcomes: intra-operative cardiovascular drug use; time to follow command before extubation; protective airway reflex recovery time after extubation. Protective airway reflex test recovery was performed at predetermined time intervals (2, 6, 14, 22 and 30 minutes) from the time to follow a standard command until the first demonstrated ability to swallow 20 ml of water in an upright position.Post-anesthesia care unit recovery data were also recorded: Ramsay sedation scale; vital signs, post-operative pain; morphine consumption.

Official Title
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A Comparison of Post-operative Recovery Between Remifentanil-propofol and Remifentanil-desflurane Anesthesia Guided by Bispectral Index Monitoring

Conditions
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Delayed Emergence From Anesthesia

Intervention / Treatment
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* Drug: Desflurane
* Drug: Propofol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female patients over 18 years old classified by the American Society of Anesthesiologists as physical status I or II, undergoing elective breast surgery with general anesthesia. Exclusion Criteria: History of: illegal drug and alcohol abuse Pregnancy on course or suspicion of Neuromuscular disorders Cerebral vascular disease Dysphagia Dysphonia Gastroesophageal reflux disease Previous larynx and/or upper gastrointestinal tract surgery Allergy to any drug to be used and malignant hyperthermia. Patients who develop hemodynamic instability in the surgery and need blood transfusion were excluded from the study. Patients unable to swallow 20 ml of water in an upright position were also excluded.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: REM-PRO<br>Total intravenous anesthesia with remifentanil and propofol, target controlled infusion based on Minto's and Marsh's pharmacokinetic models. | Drug: Propofol<br>* Total intravenous anesthesia based on propofol<br>* Other names: Diprivan;|
| Active Comparator: REM-DES<br>Balanced anesthesia with remifentanil target controlled infusion based on Minto's pharmacokinetic model and desflurane. | Drug: Desflurane<br>* Balanced anesthesia with remifentanil and desflurane guided by bispectral monitoring<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Extubation Time | Time from anesthetic discontinuation to endotracheal tube cuff deflation | Time from anesthetic discontinuation to endotracheal tube cuff deflation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Desflurane, Airway extubation, Anesthesia Recovery Period, Propofol, Intravenous anesthesia, Balanced Anesthesia