Desflurane Versus Isoflurane for Speeding Postanesthetic Recovery and Hospital Discharge

Surgery Clinical Trial

Official title:

Desflurane Versus Isoflurane for Speeding Postanesthetic Recovery and Hospital Discharge: a Cluster Randomized Crossover Trial

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT06252207
• Other study ID #: 23-1049
• Status: Not yet recruiting
• Phase: N/A
• Start date: July 1, 2024
• Est. completion date: December 1, 2025

Study information

• Verified date: May 2024
• Source: The Cleveland Clinic
• Contact: Sandra A Durbin, CLPN, CCRP
• Phone: 216-269-4073
• Email: DURBINS3[@]ccf.org
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The investigators thus propose a comparative effectiveness quality improvement project to evaluate the feasibility of switching from near-exclusive use of isoflurane in adult general surgical patients to Desflurane.

Description:

The three available volatile anesthetics appear to be comparably safe. However, higher solubility slows emergence from isoflurane and sevoflurane compared to Desflurane. Even a few minutes delay in emergence from anesthesia has financial implications since institutional costs of operating room time can easily be $30 per minute. Postoperative care is also expensive. Furthermore, in busy hospitals such as the Cleveland Clinic, inadequate recovery throughput frequently delays surgery.

The investigators thus propose a comparative effectiveness quality improvement project to evaluate the feasibility of switching from near-exclusive use of isoflurane in adult general surgical patients to Desflurane. (The investigators will exclude children because there are compelling clinical reasons to use sevoflurane in pediatric patients.) The proposed comparison is between isoflurane (our current routine) and Desflurane which is no longer used at the Clinic because of price concerns - a decision that that did not consider down-stream effects, including prolonged emergence and recovery.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 2619
• Est. completion date: December 1, 2025
• Est. primary completion date: March 1, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Adults having general anesthesia in the G operating room suite at the Cleveland Clinic Main Campus.

Exclusion Criteria:

• Operations lasting <1.5 hours.

Related Conditions & MeSH terms

• Surgery

Intervention

Drug:
• Desflurane
General anesthesia with desflurlane
• Isoflurane
General anesthesia with isoflurane

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
The Cleveland Clinic

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Duration of post-anesthesia care unit recovery	Time from entry to the post-anesthesia to discharge from unit.	1 hour
Secondary	Duration of anesthetic emergence	Time from a MAC fraction of 0.3 (presumably shortly after volatile anesthesia is discontinued) and extubation.	1 hour
Secondary	Cost of post-anesthesia care unit.	Cost of post-anesthesia unit care. To be estimated only if there is a substantial difference between the groups.	2 hours
Secondary	Delirium	Incidence of postoperative delirium.	5 days