#1 Clinical Trials Search in Europe

Desflurane

This article examines the use of desflurane, a volatile anesthetic agent, in various clinical trials. Desflurane has been studied for its effects on anesthesia, emergence, organ protection, and neurophysiological monitoring across different surgical procedures. The trials investigate desflurane’s efficacy, safety profile, and potential advantages compared to other anesthetic agents.

Table of Contents

What is Desflurane?

Desflurane, also known by its brand name Suprane[1], is a modern inhalational anesthetic agent used in medical practice. It belongs to a class of drugs called volatile anesthetics, which are gases that can be inhaled to induce and maintain general anesthesia during surgical procedures[2]. Anesthesia is a state of controlled unconsciousness that allows patients to undergo surgery without feeling pain or discomfort.

Uses of Desflurane

Desflurane is primarily used for the following purposes:

  • General Anesthesia: It is used to induce and maintain a state of unconsciousness during various surgical procedures[2].
  • Pediatric Surgeries: Desflurane can be used in children for maintaining anesthesia during operations[2].
  • Bariatric Surgery: It is used in surgeries for obese patients undergoing weight loss procedures[3].
  • Spinal Surgery: Desflurane is employed in operations involving the spine[4].
  • Neurosurgery: It is used in brain surgeries, such as those for hemifacial spasm (a condition causing facial muscle twitches)[5].

How Desflurane Works

Desflurane works by affecting the central nervous system to produce unconsciousness and prevent the sensation of pain. It has a low blood-gas solubility coefficient of 0.47, which means it is quickly absorbed and eliminated from the body[2]. This property allows for rapid onset of anesthesia and quick recovery after surgery.

The depth of anesthesia is often measured in terms of Minimum Alveolar Concentration (MAC). For Desflurane, different MAC levels can be used depending on the surgical requirements. For example, some studies have investigated using 0.5 MAC, 0.75 MAC, and 1.0 MAC of Desflurane[4].

Advantages of Desflurane

Desflurane offers several advantages in anesthesia practice:

  • Rapid Recovery: Due to its low solubility, patients typically wake up quickly after Desflurane anesthesia[3].
  • Precise Control: Anesthesiologists can easily adjust the depth of anesthesia during surgery[4].
  • Minimal Liver Metabolism: Unlike some other anesthetics, Desflurane undergoes minimal processing in the liver, which may be beneficial for certain patients[6].
  • Potential Protective Effects: Some research suggests that Desflurane might have protective effects on organs during surgery, a concept known as pharmacological preconditioning[6].

Desflurane in Specific Surgeries

Desflurane is used in various types of surgeries, each with specific considerations:

  • Bariatric Surgery: In weight loss surgeries, Desflurane may help reduce postoperative nausea and vomiting, which are common concerns in these procedures[3].
  • Neurosurgery: For brain surgeries, Desflurane’s quick offset allows for rapid neurological evaluation after the procedure[5].
  • Spinal Surgery: In spine operations, Desflurane can be used while monitoring nerve function to ensure the safety of the procedure[4].
  • Liver Surgery: Some studies are investigating whether Desflurane can help protect the liver during surgeries that temporarily cut off its blood supply[6].

Potential Side Effects

While Desflurane is generally considered safe, it can have some side effects:

  • Respiratory Irritation: Desflurane can sometimes irritate the airways, especially when used for induction of anesthesia in children[2].
  • Postoperative Nausea and Vomiting: These are common side effects after any general anesthesia, including Desflurane[3].
  • Emergence Agitation: Some patients may experience confusion or agitation when waking up from Desflurane anesthesia[1].

Ongoing Research

Researchers are continually studying Desflurane to understand its effects better and explore new applications:

  • Organ Protection: Studies are investigating whether Desflurane can help protect organs like the liver during surgery[6].
  • Cognitive Function: Research is ongoing to determine how Desflurane affects cognitive function after surgery, especially in brain and spine operations[7].
  • Cancer Surgery: Some studies are looking at how different anesthetics, including Desflurane, might affect circulating tumor cells in cancer patients undergoing surgery[8].

In conclusion, Desflurane is a valuable tool in modern anesthesia practice, offering rapid onset and recovery with a good safety profile. However, like all medical treatments, it should be used under the careful supervision of trained healthcare professionals who can tailor its use to each patient’s specific needs and medical condition.

Aspect Details
Primary Uses Induction and maintenance of general anesthesia
Studied Procedures Spinal surgery, liver resections, cardiac operations, pediatric urologic surgeries
Potential Benefits Rapid emergence, possible organ protection, titratability
Comparisons Sevoflurane, propofol, total intravenous anesthesia (TIVA)
Monitoring Methods Evoked potentials, bispectral index (BIS), circulating tumor cells
Special Populations Pediatric patients, neurosurgical patients
Areas of Investigation Emergence agitation, organ protection, impact on neurophysiological monitoring

FAQ

  • What is desflurane? Desflurane is a volatile anesthetic agent used for induction and maintenance of general anesthesia. It is inhaled and provides rapid onset and offset of anesthesia.
  • How does desflurane compare to other anesthetics? Studies have compared desflurane to agents like sevoflurane and propofol. Desflurane may offer faster recovery in some cases, but effects can vary based on dosage and patient factors.
  • What are some potential benefits of using desflurane? Potential benefits include rapid emergence from anesthesia, organ protective effects in some surgeries, and the ability to titrate anesthetic depth. However, more research is needed to fully establish these benefits.
  • Are there any risks or side effects associated with desflurane? Like all anesthetics, desflurane can have side effects such as nausea, vomiting, and respiratory irritation. It may also impact neurophysiological monitoring in some cases. The specific risks depend on patient factors and dosage.
  • What types of surgeries have studied desflurane use? Clinical trials have examined desflurane in a variety of surgeries including spinal procedures, liver resections, cardiac operations, and pediatric urologic surgeries. Its effects may vary based on the specific procedure and patient population.

Ongoing Clinical Trials on Desflurane

  • Study on Desflurane, Sevoflurane, and Propofol for Postoperative Delirium in Elderly Patients Undergoing Major Abdominal Surgery

    Recruiting

    3 1 1 1
    Investigated diseases:
    Investigated drugs:
    Austria

Glossary

  • Minimum Alveolar Concentration (MAC): A measure of anesthetic potency, representing the concentration of inhaled anesthetic required to prevent movement in 50% of patients in response to surgical stimulation.
  • Total Intravenous Anesthesia (TIVA): A technique of general anesthesia that uses a combination of intravenous drugs without inhaled agents.
  • Evoked Potentials: Electrical signals produced by the nervous system in response to stimuli, used to monitor neural function during surgery.
  • Emergence Agitation: A state of confusion, irritability or distress that can occur as a patient emerges from anesthesia, particularly common in children.
  • Pharmacological Preconditioning: The use of drugs to protect organs from potential damage before a planned period of reduced blood flow, such as during surgery.
  • Ischemia-Reperfusion Injury: Tissue damage caused when blood supply returns to tissue after a period of lack of oxygen.
  • Bispectral Index (BIS): A measure of depth of anesthesia based on electroencephalogram (EEG) data.
  • Circulating Tumor Cells (CTC): Cancer cells that have detached from a tumor and entered the bloodstream.
  • Microvascular Decompression (MVD): A surgical procedure to treat conditions caused by blood vessels compressing cranial nerves.
  • Laryngeal Mask Airway (LMA): A device used in anesthesia to maintain an open airway without tracheal intubation.

References

  1. https://clinicaltrials.gov/study/NCT01924871
  2. https://clinicaltrials.gov/study/NCT04771962
  3. https://clinicaltrials.gov/study/NCT03727607
  4. https://clinicaltrials.gov/study/NCT04717102
  5. https://clinicaltrials.gov/study/NCT01726725
  6. https://clinicaltrials.gov/study/NCT03848780
  7. https://clinicaltrials.gov/study/NCT02987218
  8. https://clinicaltrials.gov/study/NCT02335151