What is the clinical evidence from this study?

Study design: RCT. Population: Supratentorial lesions (n=60). Intervention: Desflurane vs. Isoflurane. Primary outcome: Emergence time (minutes) (p=0.001).

January 20, 2019Academia Anesthesiologica InternationalOpen Access

A Comparison of Emergence Characteristics, Intraoperative Haemodynamics and Intraoperative Brain Relaxation between Isoflurane and Desflurane in Patients Undergoing Craniotomy for Supratentorial Lesions.

View Full Paper

Ask AI

Bookmark

Key result

Desflurane significantly reduced emergence time compared to isoflurane (8.53 vs 14.10 minutes, p=0.001) in patients undergoing elective supratentorial craniotomy.

Why the study?

Few studies have compared isoflurane and desflurane for maintenance of general anesthesia in patients undergoing elective supratentorial craniotomy.

Does desflurane improve emergence characteristics compared to isoflurane in patients undergoing craniotomy for supratentorial lesions?

Study Design

Type

RCT (n=60)

Blinding

Single-blind

Randomization

Computer generated randomization list

Multicenter

Structured PICO

Does desflurane improve emergence characteristics compared to isoflurane in patients undergoing craniotomy for supratentorial lesions?

Population

60 adults aged 20-60 years with ASA status I-II and GCS >12 undergoing elective supratentorial craniotomy for space-occupying lesions.

Intervention

Desflurane + oxygen and air (50%:50%) in MAC (0.8-1.2) during maintenance of general anesthesia.

Comparator

Isoflurane + oxygen and air (50%:50%) in MAC (0.8-1.2) during maintenance of general anesthesia.

Outcome

Emergence characteristics (emergence time, tracheal extubation time, emergence hypertension, post-operative nausea and vomiting, shivering, and awareness).surrogate

Main Result

Absolute Event Rate: 8.53% vs 14.1%

p-value: p=0.001

Desflurane provides faster emergence and extubation compared to isoflurane in patients undergoing supratentorial craniotomy, without compromising hemodynamics or brain relaxation.

Limitations

Did not monitor intracranial pressure, relying instead on neurosurgeon satisfaction
Cost of desflurane was not considered
Sample size was likely not adequate to clearly establish supremacy of desflurane
Preliminary trial design requiring confirmation by a large multicenter randomized clinical trial
Lack of intracranial pressure monitoring
Cost of desflurane not considered
Small sample size
Preliminary trial design

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

May shorten emergence after craniotomy; leaves open effects on outcomes and need for RCTs.

Cite This Study

Chahar et al. (2019) conducted an RCT in Supratentorial lesions (n=60). Desflurane vs. Isoflurane was evaluated on Emergence time (minutes) (p=0.001). Desflurane significantly reduced emergence time compared to isoflurane (8.53 vs 14.10 minutes, p=0.001) in patients undergoing elective supratentorial craniotomy.

synapsesocial.com/papers/6a79cac31ba4614d7ff3a9f7 https://doi.org/10.21276/aan.2018.3.2.5

View Full Paper

Ask AI

Bookmark

A Comparison of Emergence Characteristics, Intraoperative Haemodynamics and Intraoperative Brain Relaxation between Isoflurane and Desflurane in Patients Undergoing Craniotomy for Supratentorial Lesions.

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

A Comparison of Emergence Characteristics, Intraoperative Haemodynamics and Intraoperative Brain Relaxation between Isoflurane and Desflurane in Patients Undergoing Craniotomy for Supratentorial Lesions.

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider