TITLE

Respiratory resistance during anaesthesia with isoflurane, sevoflurane, and desflurane: a randomized clinical trial

AUTHOR(S)
Nyktari, V.; Papaioannou, A.; Volakakis, N.; Lappa, A.; Margaritsanaki, P.; Askitopoulou, H.
PUB. DATE
September 2011
SOURCE
BJA: The British Journal of Anaesthesia;Sep2011, Vol. 107 Issue 3, p454
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background To investigate whether the effects of desflurane on inspiratory resistance are similar to those of isoflurane and sevoflurane during 30 min administration at 1 and 1.5 MAC in patients with healthy lungs. Methods Seventy-one patients undergoing elective surgery were randomly assigned to receive isoflurane, sevoflurane, or desflurane. Baseline inspiratory resistance was obtained after intubation and establishment of volume control ventilation. Anaesthesia was maintained with desflurane, isoflurane, or sevoflurane at 1 MAC for 30 min followed by 1.5 MAC for another 30 min. Tidal volume, flow, and inspiratory pressures were continuously recorded with a pneumotachograph. Total inspiratory resistance (Rrs), minimal resistance (Rmin), and effective resistance (DRrs) were calculated every 5 min using the end-inspiratory occlusion technique. Results No significant differences of the evaluated parameters (Rrs, Rmin and DRrs) were observed during administration of the three agents at 1 MAC for 30 min. At 1.5 MAC, desflurane caused a maximum increase in Rrs by 26% and in Rmin by 30% above baseline, in contrast to isoflurane and sevoflurane which did not display a significant effect on Rrs (+3.7% by isoflurane and +7.6% by sevoflurane) and Rmin (+4.7% by isoflurane and +9.6% by sevoflurane). All parameters returned to baseline after discontinuation of the volatile agent. Conclusions In healthy adults, neither sevoflurane nor isoflurane produced bronchodilation at 1 and 1.5 MAC. Desflurane did not affect respiratory resistance at 1 MAC, but at 1.5 MAC caused significant increase in both total and airway resistance with return to near baseline values after discontinuation of the agent.
ACCESSION #
64852899

 

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