To Compare Effect of Sevoflurane Versus Desflurane on the Return of Swallowing Reflexes in the Elderly
Status:
Completed
Trial end date:
2013-04-01
Target enrollment:
Participant gender:
Summary
Anaesthesia and surgery has become more common in the elderly as the population survives
longer. Anaesthesia in the elderly confers a higher risk which is related to the aging
process and the diseases that accompany seniority. As such, there is a need to provide
optimal anaesthetic management in order to minimize complications and risks perioperatively.
One of the changes associated with ageing is the progressive decrease in protective laryngeal
reflexes. Any depression of upper airway reflexes increases the chance of pulmonary
aspiration and compromises the maintenance of the airway.
Desflurane is an inhalational agent strongly favored due to its lower solubility in blood,
lean tissue and fat as compared to sevoflurane. This enables the agent to be quickly
eliminated at the end of surgery, with minimal metabolic breakdown, thus facilitating more
rapid emergence as compared to sevoflurane anesthesia in elderly undergoing general
anaesthesia. McKay et al conducted a study in 2005 in US, which showed that the choice of
inhalational agent itself can influence the return of protective airway reflexes. In the
study, the inhalational agent sevoflurane was found to cause significant impairment of
swallowing, in comparison with desflurane(1). However, the aforementioned study focussed on
the general population. As such, the purpose of this study is to determine whether the choice
of inhalational anesthetic (sevoflurane versus desflurane) has similar influence on the
return of protective airway reflexes in the geriatric population in Malaysia, and whether the
significance is greater in the elderly population.