Multicenter randomized comparison of the efficacy and safety of xenon and isoflurane in patients undergoing elective surgery.
BACKGROUND
All general anesthetics used are known to have a negative inotropic side effect. Since xenon does not have a negative inotropic effect, it could be an interesting future general anesthetic. The aim of this clinical multicenter trial was to test the hypothesis of whether recovery after xenon anesthesia is faster compared with an accepted, standardized anesthetic regimen and that it is as effective and safe.


METHODS
A total of 224 patients in six centers were included in the protocol. They were randomly assigned to receive either xenon (60 +/- 5%) in oxygen or isoflurane (end-tidal concentration, 0.5%) combined with nitrous oxide (60 +/- 5%). Sufentanil (10 mcirog) was intravenously injected if indicated by defined criteria. Hemodynamic, respiratory, and recovery parameters, the amount of sufentanil, and side effects were assessed.


RESULTS
The recovery parameters demonstrated a statistically significant faster recovery from xenon anesthesia when compared with isoflurane-nitrous oxide. The additional amount of sufentanil did not differ between both anesthesia regimens. Hemodynamics and respiratory parameters remained stable throughout administration of both anesthesia regimens, with advantages for the xenon group. Side effects occurred to the same extent with xenon in oxygen and isoflurane-nitrous oxide.


CONCLUSIONS
This first randomized controlled multicenter trial on the use of xenon as an inhalational anesthetic confirms, in a large group of patients, that xenon in oxygen provides effective and safe anesthesia, with the advantage of a more rapid recovery when compared with anesthesia using isoflurane-nitrous oxide.
Rossaint
Rolf
R
Department of Anesthesiology of the University Hospital, RWTH Aachen, Germany. rossaint@post.rwth-aachen.de
Reyle-Hahn
Matthias
M
Schulte Am Esch
Jochen
J
Scholz
Jens
J
Scherpereel
Philippe
P
Vallet
Benoit
B
Giunta
Francesco
F
Del Turco
Monica
M
Erdmann
Wilhelm
W
Tenbrinck
Rob
R
Hammerle
Alfons F
AF
Nagele
Peter
P
D000759:Adjuvants, Anesthesia; D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation; D018685:Anesthetics, Inhalation / Q000009:adverse effects / Q000191:economics; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D004311:Double-Blind Method; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000191:economics; D005260:Female; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal; D007530:Isoflurane / Q000009:adverse effects / Q000191:economics; D008297:Male; D008874:Midazolam; D008875:Middle Aged; D011229:Preanesthetic Medication; D018401:Sample Size; D013997:Time Factors; D014978:Xenon / Q000009:adverse effects / Q000191:economics
D000759:Adjuvants, Anesthesia; D018685:Anesthetics, Inhalation; D014978:Xenon; D007530:Isoflurane; D008874:Midazolam