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

Overview

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 Title of Study: “Optimal End-Tidal Concentration of Sevoflurane and Desflurane for Removal of Supreme Laryngeal Mask Airway in Anaesthetized Adults”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Supportive Care
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: July 2010

Detailed 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.

Interventions

  • Drug: Sevoflurane
    • Comparing the optimal end-tidal concentration sevoflurane and desflurane for LMA extubation
  • Drug: Desflurane
    • Comparing the optimal end-tidal concentration sevoflurane and desflurane for LMA extubation

Arms, Groups and Cohorts

  • Experimental: Sevoflurane
    • 1 arm will receive sevoflurane at varying concentrations at which extubation is attempted according to the Dixon up and down method
  • Experimental: Desflurane
    • 1 arm will receive desflurane at varying end tidal concentration at which extubation will be attempted according to Dixon up and down method

Clinical Trial Outcome Measures

Primary Measures

  • Optimal end tidal concentration of sevoflurane/ desflurane
    • Time Frame: 6 months

Secondary Measures

  • presence of airway response
    • Time Frame: 10 mins after surgery

Participating in This Clinical Trial

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

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 49 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • University of Malaya
  • Collaborator
    • Malaysian Society of Anaesthesiologists
  • Provider of Information About this Clinical Study
    • Principal Investigator: Cindy Thomas Joseph, doctor – University of Malaya
  • Overall Official(s)
    • Cindy Thomas Joseph, Principal Investigator, Department of Anaesthesiology, UMMC

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