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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