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Bronchial mucus transport velocity in patients receiving desflurane and fentanyl vs. sevoflurane and fentanyl

Published online by Cambridge University Press:  01 September 2008

T. Ledowski ,
A. Manopas  and
S. Lauer
T. Ledowski*
Affiliation:
Royal Perth Hospital, Department of Anaesthesia and Pain Medicine, Perth, Western Australia
A. Manopas
Affiliation:
Royal Perth Hospital, Department of Anaesthesia and Pain Medicine, Perth, Western Australia
S. Lauer
Affiliation:
Royal Perth Hospital, Department of Anaesthesia and Pain Medicine, Perth, Western Australia
*
Correspondence to: Thomas Ledowski, Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Wellington Street Campus, Perth WA 6000, Australia. E-mail: [email protected]; Tel: +61 8 9224 1036; Fax: +61 8 9224 1111
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Summary

Background and objective

Sevoflurane has been shown to distinctly reduce bronchial mucus transport velocity, an essential determinant of mucociliary clearance and pulmonary complications. However, sevoflurane is regarded as one of the least irritant volatile anaesthetics, especially when compared with desflurane. Hence, the aim of this double-blind, randomized, controlled trial was to assess differences in bronchial mucus transport velocity between sevoflurane and desflurane.

Methods

Twenty patients listed for general surgery were randomized to receive either maintenance of anaesthesia with desflurane and fentanyl, or sevoflurane and fentanyl. Thirty minutes after tracheal intubation, bronchial mucus transport velocity was assessed by fibreoptic observation of the movement of methylene blue dye applied to the dorsal surface of the right main bronchus.

Results

Both agents distinctly reduced bronchial mucus transport velocity when compared with previous studies, but the degree of impairment did not significantly differ between the investigated groups (median [25%/75% percentile]): desflurane 1.5 [0.5/4.2] vs. sevoflurane 1.3 [0.3/2.9] mm min−1, P = 0.343).

Conclusions

Desflurane is commonly regarded as more irritant to the airway, but as far as bronchial mucus transport velocity is concerned, the choice between sevoflurane and desflurane does not seem to matter.

Keywords

ANAESTHESIA INHALATIONALDESFLURANESEVOFLURANEMUCUSBRONCHIAL, transport velocity
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 9 , September 2008 , pp. 752 - 755
Copyright
Copyright © European Society of Anaesthesiology 2008

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