Skip to main content Accessibility help
×
Home

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

  • T. Ledowski (a1), A. Manopas (a1) and S. Lauer (a1)

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.

Copyright

Corresponding author

Correspondence to: Thomas Ledowski, Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Wellington Street Campus, Perth WA 6000, Australia. E-mail: thomas.ledowski@health.wa.gov.au; Tel: +61 8 9224 1036; Fax: +61 8 9224 1111

References

Hide All
1.Konrad, F, Schreiber, T, Brecht-Kraus, D et al. Mucociliary transport in ICU patients. Chest 1994; 105 (1): 237241.
2.Raphael, JH, Selwyn, DA, Mottram, SD et al. Effects of 3 MAC of halothane, enflurane and isoflurane on cilia beat frequency of human nasal epithelium in vitro. Br J Anaesth 1996; 76 (1): 116121.
3.Raphael, JH, Strupish, J, Selwyn, DA et al. Recovery of respiratory ciliary function after depression by inhalation anaesthetic agents: an in vitro study using nasal turbinate explants. Br J Anaesth 1996; 76 (6): 854859.
4.Raphael, JH, Butt, MW. Comparison of isoflurane with propofol on respiratory cilia. Br J Anaesth 1997; 79 (4): 473475.
5.Ledowski, T, Paech, MJ, Patel, B et al. Bronchial mucus transport velocity in patients receiving propofol and remifentanil versus sevoflurane and remifentanil anesthesia. Anesth Analg 2006; 102 (5): 14271430.
6.TerRiet, MF, DeSouza, GJ, Jacobs, JS et al. Which is most pungent: isoflurane, sevoflurane or desflurane? Br J Anaesth 2000; 85 (2): 305307.
7.Keller, C, Brimacombe, J. Bronchial mucus transport velocity in paralyzed anesthetized patients: a comparison of the laryngeal mask airway and cuffed tracheal tube. Anesth Analg 1998; 86 (6): 12801282.
8.Sackner, MA, Rosen, MJ, Wanner, A. Estimation of tracheal mucous velocity by bronchofiberscopy. J Appl Physiol 1973; 34 (4): 495499.
9.Wanner, A, Salathe, M, O’Riordan, TG. Mucociliary clearance in the airways. Am J Respir Crit Care Med 1996; 154 (6 Pt 1): 18681902.
10.Knowles, MR, Boucher, RC. Mucus clearance as a primary innate defense mechanism for mammalian airways. J Clin Invest 2002; 109 (5): 571577.
11.Konrad, FX, Schreiber, T, Brecht-Kraus, D et al. Bronchial mucus transport in chronic smokers and nonsmokers during general anesthesia. J Clin Anesth 1993; 5 (5): 375380.
12.Arain, SR, Shankar, H, Ebert, TJ. Desflurane enhances reactivity during the use of the laryngeal mask airway. Anesthesiology 2005; 103 (3): 495499.
13.Klock, PA Jr, Czeslick, EG, Klafta, JM et al. The effect of sevoflurane and desflurane on upper airway reactivity. Anesthesiology 2001; 94 (6): 963967.
14.Cervin, A, Lindberg, S. Changes in mucociliary activity may be used to investigate the airway-irritating potency of volatile anaesthetics. Br J Anaesth 1998; 80 (4): 475480.
15.Ledowski, T, Hilmi, S, Paech, MJ. Bronchial mucus transport velocity in patients receiving anaesthesia with propofol and morphine or propofol and remifentanil. Anaesthesia 2006; 61 (8): 747751.

Keywords

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

  • T. Ledowski (a1), A. Manopas (a1) and S. Lauer (a1)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed