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: 0
• Participant gender: All

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.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University of Malaya
• Treatments: Desflurane; Isoflurane; Sevoflurane

Criteria

Inclusion Criteria:

• Age 60-85 years' old

• Both male and female patients

• ASA I-II

• Body mass index (BMI) ≤ 30 kg/m2

• Elective surgery under general anaesthesia with the use of laryngeal mask airway (LMA) / LMA Proseal / LMA Supreme

• Type of surgery: Urogynecological, General Surgery, Orthopedics, Eye, Vascular, Plastic

• Surgery/anaesthesia lasting for 0.5-3 hours

Exclusion Criteria:

• Patients with difficulty in swallowing, preexisting neuromuscular or central nervous system disorder

• Patients undergoing intra abdominal, thoracic, face, nasal or throat surgery

• Known condition interfering with gastric emptying

• Patients with cognitive or hearing impairment and inability to provide informed consent

• ASA III-IV patients

• Use of muscle relaxant during the course of general anesthesia

• Contraindication or previous adverse response to any of the study drugs