Publication: Comparing the efficacy between desflurane and sevoflurane in maintenance of spontaneous general anaesthesia using ambuòauragainô in paediatric patients: a randomised controlled trial.
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Date
2020
Authors
Hamzah, Tengku Nordiana Tengku
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Abstract
Desflurane has a rapid onset and offset of anaesthesia, thus minimising complications associated with prolonged recovery compared to sevoflurane. Nevertheless, due to its pungency, it is avoided as induction agent in paediatric as it may cause airway irritability. This study aimed to evaluate the haemodynamic, emergence time, emergence agitation and respiratory adverse event of desflurane in comparison to sevoflurane in maintaining general anaesthesia with spontaneous breathing in paediatric population using AmbuÒAuraGainÔ, as previous studies were done in paralysed and controlled ventilated patients. This study was prospective, single blinded, single centre and randomised controlled trial. A total of 80 American Society of Anaesthesiologists (ASA) physical status I children patients underwent short (1 to 2 hours) elective surgeries were randomised into two groups; sevoflurane (Group S, n = 40): and desflurane (Group D, n = 40) for maintenance of spontaneous breathing general anaesthesia. Both groups were observed for emergence time, frequency and severity of emergence agitation, the respiratory adverse events and intraoperative and post-operative haemodynamic of every 10 minutes. All data were analysed using independent t-test, Pearson chi-squared and repeated measures ANOVA respectively. Emergence time was significantly shorter [6.92(2.47) vs 9.95(55.52), P = 0.003] with reduced frequency and severity of emergence agitation (P = 0.014) in desflurane group compare to sevoflurane. However, there was no significance difference in term of intraoperative haemodynamic for SBP, DBP, MAP and HR and perioperative respiratory adverse events in both groups (P > 0.05 respectively). Maintenance of general anaesthesia with spontaneous breathing in paediatrics using desflurane had faster emergence time with reduced frequency and severity of emergence agitation as compared to sevoflurane.
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Keywords
Anaesthetics , paediatric , inhalational , desflurane , sevoflurane