Bronchial mucus transport velocity in patients receiving desflurane and fentanyl vs. sevoflurane and fentanyl.
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.
Ledowski
T
T
Royal Perth Hospital, Department of Anaesthesia and Pain Medicine, Perth, Western Australia, Australia. thomas.ledowski@health.wa.gov.au
Manopas
A
A
Lauer
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology; D001980:Bronchi; D000077335:Desflurane; D004311:Double-Blind Method; D005283:Fentanyl / Q000494:pharmacology; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000494:pharmacology; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D009079:Mucociliary Clearance / Q000187:drug effects*; D012129:Respiratory Function Tests; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane; D005283:Fentanyl