Optimal End-Tidal (ET) Sevoflurane and Desflurane Concentration for Extubation of Supreme Laryngeal Mask Airway (LMA) in Adults

University of Malaya

Status: Completed

Conditions: Airway Complications

Treatments: Drug: Desflurane; Drug: Sevoflurane

Study type: Interventional

Funder types: Other

Identifiers

NCT01083953

supreme sevo vs des

Details and patient eligibility

About

The purpose of this study is to determine the optimal volatile anaesthetic (sevoflurane and desflurane) to remove a Supreme LMA in adults in which there is minimal airway response.

Null hypothesis: there is no significant difference between the optimal end tidal concentration of sevoflurane and desflurane for Supreme LMA removal.

Full description

The manufactures' instructions for removal of the LMA recommend waiting until protective reflexes have returned. However, the appropriate timing for removal remains controversial. A more frequent incidence of airway hyperreactivity and complications has been reported by some studies when the LMA was removed in the awake state versus the anesthetized state. Techniques that reduce the time from LMA removal to the return of protective airway reflexes would minimize the risk of aspiration, contamination, or airway obstruction.

With increasingly common use of Supreme LMA in anaesthetic practice, a safe and suitable depth for removal of the Supreme LMA requires research.

Thus the determination of the optimal end-tidal concentration of commonly used volatile agents ie. Sevoflurane and Desflurane for Supreme LMA removal requires research, both for patient safety and minimising anaesthetic costs in dealing with airway complications.

Enrollment: 54 patients

Sex: All

Ages: 18 to 49 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. ASA 1-2 patients
2. Age 18 - 49 years old
3. Elective surgery of short duration ( < 2 hours ) which require local anaesthetic infiltration

Exclusion criteria

1. Upper respiratory tract symptoms in the previous 10 days
2. Risk of gastric oesophageal reflux or regurgitation
3. Known or predicted difficult airway
4. Poor dentition with high risk of damage
5. BMI > 30 kg/m2
6. Refusing to participate

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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54 participants in 2 patient groups

Sevoflurane

Experimental group

Description:

1 arm will receive sevoflurane at varying concentrations at which extubation is attempted according to the Dixon up and down method

Treatment:

Drug: Sevoflurane

Desflurane

Experimental group

Description:

1 arm will receive desflurane at varying end tidal concentration at which extubation will be attempted according to Dixon up and down method

Treatment:

Drug: Desflurane