Comparison of the Level of Free Hexafluoro-isopropanol in Adults' Blood and the Incidence of Emergence Agitation After Anesthesia With Different Concentrations of Sevoflurane in Laparoscopic Gastrointestinal Surgery: A Randomized Controlled Clinical Trial.

Abstract

PURPOSE:

The aim of the study is to compare the free hexafluoro-isopropanol (HFIP) concentration in adults' blood and the incidence of emergence agitation (EA) after inhaled different concentrations of sevoflurane.

METHODS:

Sixty adult patients planning to undergo laparoscopic gastrointestinal surgery were randomly assigned to 3 groups. Each group received sevoflurane as the volatile anesthetic at different concentrations: 0.5 minimum alveolar concentration (MAC), 1.0 MAC, and 1.5 MAC. The use of sevoflurane was continued until the end of surgery. Venous blood samples were obtained at 30, 60, 120, and 180 minutes after starting the use of sevoflurane and subsequently at 60, 180, and 300 minutes after discontinuation of volatile anesthetic administration. Blood concentrations of sevoflurane and free HFIP were determined using gas chromatography. The recovery time and the incidence of EA at different time points were evaluated among the 3 groups.

FINDINGS:

Changes in the blood concentrations of sevoflurane and free HFIP during and after the use of sevoflurane were similar in all 3 groups. The peak blood concentration of free HFIP occurred 60 minutes after onset of sevoflurane anesthesia in all 3 groups (P < 0.05). The lowest level of free HFIP and the longest recovery time were found in the 1.5-MAC group (P < 0.05). No significant difference was found in the incidence of EA or moderate pain among the 3 groups during recovery.

IMPLICATIONS:

The generation of HFIP would be inhibited when the inhaled sevoflurane concentration increased to 1.5 MAC. However, the incidence of EA during recovery had nothing to do with the inhaled different sevoflurane concentrations (within 1.5 MAC) in adults. ChicCTR.org identifier: ChiCTR-IPD-17011558.

• Authors: Yan Feng, Xiao-Bo Chen, Wei-Guo Yuan, San Huang, Ming Li, Xiao-Lin Yang
• Journal: Clinical therapeutics (Clin Ther) Vol. 41 Issue 11 Pg. 2263-2272 (11 2019) ISSN: 1879-114X [Electronic] United States
• PMID: 31561881 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.

Chemical References

• Anesthetics, Inhalation
• Propanols
• Sevoflurane
• hexafluoroisopropanol

Topics

• Aged
• Anesthesia
• Anesthetics, Inhalation (administration & dosage, adverse effects, pharmacokinetics)
• Digestive System Surgical Procedures
• Dose-Response Relationship, Drug
• Double-Blind Method
• Emergence Delirium (blood, chemically induced)
• Female
• Humans
• Laparoscopy
• Male
• Middle Aged
• Propanols (blood)
• Sevoflurane (administration & dosage, adverse effects, pharmacokinetics)