To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: ASA: Desflurane at High Concentrations Appears to Have More Adverse Events Than Sevoflurane URL: http://www.pslgroup.com/dg/24763A.htm Doctor's Guide October 27, 2004
By Michael Smith LAS VEGAS, NV -- October 27, 2004 -- High concentrations of the anesthetic agent desflurane leads to more body movements, coughing and breath holding than does sevoflurane, according to a study reported here on October 26th at the American Association of Anesthesiologists Annual Meeting. Investigator Hariharan Shankar, MD, Pain Management Fellow, Department of Anesthesiology Medical College of Wisconsin in Milwaukee, Milwaukee, Wisconsin, said that the genesis of the study was a report last year that the two drugs had equivalent and minimal effects on airway irritation, at least at relatively low concentrations. "But we have seen, time and again, when we use desflurane, it does increase airway responses," he explained (Anesth Analg. 2003 Mar;96(3):701-5). Dr. Shankar pointed out that confounding factors -- such as the use of nitrous oxide with both drugs and a higher use of opioids with desflurane -- might have contributed to the earlier finding. To determine the effect of the two agents at higher doses, Dr. Shankar and colleagues conducted a randomized study of 60 patients who received anesthesia via laryngeal mask airway before elective surgery. An independent observer, who did not know which drug was being used, monitored the patients for movement, coughing and breath holding. Five minutes after initiating drug administration, the mask cuff was deflated and the airway moved up and down before it was re-inflated. Two minutes later, the inspiratory anesthetic concentration was changed to a minimum alveolar concentration (MAC) of 2 equivalent for 3 more minutes before surgery began. At low concentrations MAC equivalent of 1, there was no difference between the two drugs, Dr. Shankar said. There was also no difference during the movement of the mask. But after the mask cuff was re-inflated and the anesthetic concentration was increased to a MAC equivalent of 2, desflurane patients showed significantly more responses. Their incidence of coughing was 53%, movements 47%, and breath-holding 52%. None of the sevoflurane patients had any of those reactions, Dr. Shankar said. The results were statistically significant at the P < .05 confidence level. He concluded that desflurane irritates the airway enough so that its use could be a problem in some patients, especially at higher concentrations. [Presentation title: Reactivity to LMA with Desflurane and Sevoflurane." Abstract A-69] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.