Comparative Evaluation of Modern Inhalation Anesthetics in Carotid Endarterectomy
https://doi.org/10.15360/1813-9779-2019-1-27-38
Abstract
The purpose of the study was to compare the possibility of rapid activation of elderly patients after carotid endarterectomy performed under sevoflurane- or desflurane-based anesthesia. Materials and methods. 67 patients aged 75 to 89 years divided into two groups were examined. To maintain anesthesia, desflurane was used in the 1st group and sevoflurane was employed in the 2nd group. Results. Patients from the group receiving desflurane, experienced decreased ability to take a sip of water and to hold oneself in a sitting position, and were characterized by decreased time before the tracheal extubation. Conclusion. Desflurane-based anesthesia provided faster awakening and activation of elderly patients after carotid endarterectomy than the anesthesia with sevoflurane, which allowed to implement the fast-track recovery protocol. In addition, the desflurane-based anesthesia provided excellent manageability and less negative impact on the hemodynamics (within the drug concentration range of up to 1.3 MAC).
About the Authors
V. A. Aliev
I. M. Sechenov First Moscow State Medical University, Ministry of Health of Russia;
GMS Clinic and Hospitals
Russian Federation
Russian Federation
A. G. Yavorovskii
I. M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
A. A. Shaposhnikov
I. M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
I. Zh. Loriya
I. M. Sechenov First Moscow State Medical University, Ministry of Health of Russia;
GMS Clinic and Hospitals
Russian Federation
Russian Federation
M. S. Vetsheva
I. M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
References
1. Narbutas K., Lekas R., Rimkiene A., Civinskiene G. Characteristics of general anesthesia in the investigation of heart electrophysiology. Medicina (Kaunas). 2002; 38 (8): 843–848. DOI: PMID: 12474758
2. Turrentine F.E., Wang H., Simpson V.B., Jones R.S. Surgical risk factors, morbidity, and mortality in elderly patients. J. Am. Coll. Surg. 2006; 203 (6): 865-877. DOI: 10.1016/j.jamcollsurg.2006.08.026. PMID: 17116555
3. Korkushko O.V. Geriatric aspects of cardiovascular disease. In: Chazov E.I. (ed.). Diseases of the heart and blood vessels. v.4. Moscow: Meditsina Publishers; 1992: 5–33. ISBN 5-225-02172-7. [In Russ.]
4. Shifman E.M. New ways of sub- and epidural analgesia. In: Zilber A.P. Actual problems of medicine of critical conditions. Petrozavodsk; 1997: 6–29. [In Russ.]
5. El-Baz N., Goldin M. Continuous epidural infusuion of morphine for pain relief after cardiac operations. J. Thorac. Cardiovasc. Surg. 1987; 93 (6): 878–883. DOI: PMID: 2952842
6. Van Ackern K., List W.F., Albrecht M. Anaesthesiologie und Intensivmedtzm 217. Berlin, Heidelberg: Springer-Verlag; 1991: 45–52.
7. Carter J., Philp Sh., Arora V. Early discharge after major gynaecological surgery: advantages of fast track surgery. Open J. Obstet. Gynec. 2011; 1 (1): 1–5. DOI: 10.4236/ojog.2011.11001
8. Grigoras I. Fast track surgery. J. de Chirurgie Iasi. 2007; 3 (2): 89–91.
9. Plodr M., Ferko A. Fast track in surgery. Rozhl. Chir. 2005; 84 (11): 557– 560. PMID: 16334937
10. Wang G., Jiang Z.W., Xu J., Gong J.F., Bao Y., Xie L.F., Li J.S. Fast track rehabilitation program vs conventional care after colorectal resection: a randomized clinical trial. World J. Gastroenterol. 2011; 17 (5): 671–676. DOI: 10.3748/wjg.v17.i5.671. PMID: 21350719
11. Wilmore D.W., Kehlet H. Management of patients in fast track surgery. Br. Med. J. 2001; 322 (7284): 473–476. DOI: 10.1136/bmj.322.7284.473. PMID: 11222424
12. Zonca P., Stigler J., Maly T., Neoral C., Hajek M., Stiglerova S. Do we really apply fast track surgery? Bratisl. Lek. Listy. 2008; 109 (2): 61–65. PMID: 18457311
13. Gustafsson U.O., Scott M.J., Schwenk W., Demartines N., Roulin D., Francis
14. N., McNaught C.E., Macfie J., Liberman A.S., Soop M., Hill A., Kennedy R.H., Lobo D.N., Fearon K., Ljungqvist O.; Enhanced Recovery After Surgery (ERAS) Society, for Perioperative Care; European Society for Clinical Nutrition and Metabolism (ESPEN); International Association for Surgical Metabolism and Nutrition (IASMEN). Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS(®)) Society recommendations. World J. Surg. 2013; 37 (2): 259-284. DOI: 10.1007/s00268-012-1772-0. PMID: 23052794
15. Skobelev E.I., Pasechnik I.N., Rybintsev V.Yu. Inhalation anesthesia as part of enhanced-recovery-after-surgery approach. Doktor.Ru. 2015; 15-16: 32–36. [In Russ.]
16. Dexter F., Bayman E.O., Epstein R.H. Statistical modeling of average and variability of time to extubation for meta-analysis comparing desflurane to sevoflurane. Anesth. Analg. 2010; 110 (2): 570-580. DOI: 10.1213/ANE.0b013e3181b5dcb7. PMID: 19820242
17. Agoliati A., Dexter F., Lok J., Masursky D., Sarwar M.F., Stuart S.B., Bayman E.O., Epstein R.H. Meta-analysis of average and variability of time to extubation comparing isoflurane with desflurane or isoflurane with sevoflurane. Anesth. Analg. 2010; 110 (5): 1433-1439. DOI: 10.1213/ANE.0b013e3181d58052. PMID: 20418303
18. Wachtel R.E., Dexter F., Epstein R.H., Ledolter J. Meta-analysis of desflurane and propofol average times and variability in times to extubation and following commands. Can. J. Anaesth. 2011; 58 (8): 714-724. DOI: 10.1007/s12630-011-9519-1. PMID: 21630118
19. Yasuda N., Targ A.G., Eger E.I.2nd. Solubility of I-653, sevoflurane, isoflurane, and halothane in human tissues. Anesth. Analg. 1989; 69 (3): 370-373. DOI: 10.1213/00000539-198909000-00016. PMID: 2774233
20. Bilotta F., Doronzio A., Cuzzone V., Caramia R., Rosa G.; PINOCCHIO Study Group. Early postoperative cognitive recovery and gas exchange patterns after balanced anesthesia with sevoflurane or desflurane in overweight and obese patients undergoing craniotomy: a prospective randomized trial. J. Neurosurg. Anesthesiol. 2009; 21 (3): 207-213. DOI: 10.1097/ANA.0b013e3181a19c52. PMID: 19542997
21. Li L., Saiyin H., Xie J., Ma L., Xue L., Wang W., Liang W., Yu Q. Sevoflurane preconditioning induced endogenous neurogenesis against ischemic brain injury by promoting microglial activation. Oncotarget. 2017; 8 (17): 28544-28557. DOI: 10.18632/oncotarget.15325. PMID: 28212538
22. Sedlic F., Pravdic D., Ljubkovic M., Marinovic J., Stadnicka A., Bosnjak Z.J. Differences in production of reactive oxygen species and mitochondrial uncoupling as events in the preconditioning signaling cascade between desflurane and sevoflurane. Anesth. Analg. 2009; 109 (2): 405-411. DOI: 10.1213/ane.0b013e3181a93ad9. PMID: 19608810
23. Dupont J., Tavernier B., Ghosez Y., Durinck L., Thevenot A., Moktadir-Chalons N., Ruyffelaere-Moises L., Declerck N., Scherpereel P. Recovery after anaesthesia for pulmonary surgery: desflurane, sevoflurane and isoflurane. Br. J. Anaesth. 1999; 82 (3): 355-359. DOI: 10.1093/bja/82.3.355. PMID: 10434815
24. Juvin P., Vadam C., Malek L., Dupont H., Marmuse J.P., Desmonts J.M. Postoperative recovery after desflurane, propofol, or isoflurane anesthesia among morbidly obese patients: a prospective, randomized study. Anesth. Analg. 2000; 91 (3): 714-719. DOI: 10.1097/00000539-200009000-00041. PMID: 10960406
25. Fanelli G., Berti M., Casati A. Fast-track anaesthesia for laparoscopic cholecystectomy: a prospective, randomized, multicentre, blind comparison of desflurane-remifentanil or sevoflurane-remifentanil. Eur. J. Anaesthesiol. 2006; 23 (10): 861-868. DOI: 10.1017/S0265021506000718. PMID: 16723051
26. McKay R.E., Malhotra A., Cakmakkaya O.S., Hall K.T., McKay W.R., Apfel C.C. Effect of increased body mass index and anaesthetic duration on recovery of protective airway reflexes after sevoflurane vs desflurane. Br. J. Anaesth. 2010; 104 (2): 175-182. DOI: 10.1093/bja/aep374. PMID: 20037150
27. Heavner J.E., Kaye A.D., Lin B.K., King T. Recovery of elderly patients from two or more hours of desflurane or sevoflurane anaesthesia. Br. J. Anaesth. 2003; 91 (4): 502-506. DOI: 10.1093/bja/aeg221. PMID: 14504150
28. Juvin P., Servin F., Giraud O., Desmonts J.M. Emergence of elderly patients from prolonged desflurane, isoflurane, or propofol anesthesia. Anesth. Analg. 1997; 85 (3): 647-651. DOI: 10.1097/00000539-199709000-00029. PMID: 9296424
29. De Hert S.G., Van der Linden P.J., Cromheecke S., Meeus R., ten Broecke P.W., De Blier I.G., Stockman B.A., Rodrigus I.E. Choice of primary anesthetic regimen can influence intensive care unit length of stay after coronary surgery with cardiopulmonary bypass. Anesthesiology. 2004; 101 (1): 9-20. DOI: 10.1097/00000542-200407000-00005. PMID: 15220766
30. De Hert S.G., Cromheecke S., ten Broecke P.W., Mertens E., De Blier I.G., Stockman B.A., Rodrigus I.E., Van der Linden P.J. Effects of propofol, desflurane, and sevoflurane on recovery of myocardial function after coronary surgery in elderly high-risk patients. Anesthesiology. 2003; 99 (2): 314-323. DOI: 10.1097/00000542-200308000-00013. PMID: 12883404
31. De Hert S.G., ten Broecke P.W., Mertens E., Van Sommeren E.W., De Blier
32. I.G., Stockman B.A., Rodrigus I.E. Sevoflurane but not propofol preserves myocardial function in coronary surgery patients. Anesthesiology. 2002; 97 (1): 42-49. DOI: 10.1097/00000542-200207000-00007. PMID: 12131102
33. Strum E.M., Szenohradszki J., Kaufman W.A., Anthone G.J., Manz I.L., Lumb P.D. Emergence and recovery characteristics of desflurane versus sevoflurane in morbidly obese adult surgical patients: a prospective, randomized study. Anesth. Analg. 2004; 99 (6): 1848-1453. DOI: 10.1213/01.ANE.0000136472.01079.95. PMID: 15562085
34. De Baerdemaeker L.E., Struys M.M., Jacobs S., Den Blauwen N.M., Bossuyt G.R., Pattyn P., Mortier E.P. Optimization of desflurane administration in morbidly obese patients: a comparison with sevoflurane using an ‘inhalation bolus’ technique. Br. J. Anaesth. 2003; 91 (5): 638-650. DOI: 10.1093/bja/aeg236. PMID: 14570784
35. La Colla L., Albertin A., La Colla G., Mangano A. Faster wash-out and recovery for desflurane vs sevoflurane in morbidly obese patients when no premedication is used. Br. J. Anaesth. 2007; 99 (3): 353-358. DOI: 10.1093/bja/aem197. PMID: 17621601
36. Sakai E.M., Connolly L.A., Klauck J.A. Inhalation anesthesiology and volatile liquid anesthetics: focus on isoflurane, desflurane, and sevoflurane. Pharmacotherapy. 2005; 25 (12): 1773-1788. DOI: 10.1592/phco.2005.25.12.1773. PMID: 16305297
37. Guarracino F., Landoni G., Tritapepe L., Pompei F., Leoni A., Aletti G., Scandroglio A.M., Maselli D., De Luca M., Marchetti C., Crescenzi G., Zangrillo A. Myocardial damage prevented by volatile anesthetics: a multicenter randomized controlled study. J. Cardiothorac. Vasc. Anesth. 2006; 20 (4): 477-483. DOI: 10.1053/j.jvca.2006.05.012. PMID: 16884976
38. Tritapepe L., Landoni G., Guarracino F., Pompei F., Crivellari M., Maselli D., De Luca M., Fochi O., D’Avolio S., Bignami E., Calabrò M.G., Zangrillo A. Cardiac protection by volatile anaesthetics: a multicentre randomized controlled study in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass. Eur. J. Anaesthesiol. 2007; 24 (4): 323-331. DOI: 10.1017/S0265021506001931. PMID: 17156509
Review
For citations:
Aliev V.A., Yavorovskii A.G., Shaposhnikov A.A., Loriya I.Zh., Vetsheva M.S. Comparative Evaluation of Modern Inhalation Anesthetics in Carotid Endarterectomy. General Reanimatology. 2019;15(1):27-38. (In Russ.) https://doi.org/10.15360/1813-9779-2019-1-27-38
Views:
956
Email this article 