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Anesth Analg 2006;103:1147-1154
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000237293.39466.65

AMBULATORY ANESTHESIA

Airway Responses During Desflurane Versus Sevoflurane Administration via a Laryngeal Mask Airway in Smokers

Rachel Eshima McKay, MD*, Alan Bostrom, PhD{dagger}, Michel C. Balea, MS*, and Warren R. McKay, MD*

From the *Department of Anesthesia and Perioperative Care, University of California, San Francisco, California; and {dagger}Department of Epidemiology and Biostatistics; University of California San Francisco, San Francisco, California.

Address correspondence and reprint requests to Dr McKay, Department of Anesthesia, C-450, University of California, San Francisco, CA 94143-0464. Address e-mail to eshimar{at}anesthesia.ucsf.edu.

Cigarette smokers have a greater risk of respiratory complications during anesthesia compared with nonsmokers. It is not known whether the relative pungency of an inhaled anesthetic further contributes to the smokers’ increased rate of such complications. In the present study, we tested whether the use of a more pungent anesthetic (desflurane) would result in a higher rate of coughing, breath holding, laryngospasm, or desaturation among patients who smoke. We randomly assigned 110 smokers to anesthesia with desflurane (n = 55) or sevoflurane (n = 55), administered via a laryngeal mask airway. Five patients (9%) receiving desflurane and nine patients (16%) receiving sevoflurane coughed (P = 0.39). Most coughing occurred during induction (33%) or emergence (56%), in the setting of airway manipulation and low anesthetic concentration. The rate of breath holding, laryngospasm, and desaturation was similar between those receiving desflurane versus sevoflurane. A retrospective comparison of this cohort of 110 smokers to a previous group consisting of 100 nonsmokers and 27 smokers receiving an identical anesthetic regimen indicates that cigarette smoking, but not choice of anesthetic, places patients at increased risk of respiratory complications.




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P. Hans, H. Marechal, and V. Bonhomme
Effect of propofol and sevoflurane on coughing in smokers and non-smokers awakening from general anaesthesia at the end of a cervical spine surgery
Br. J. Anaesth., November 1, 2008; 101(5): 731 - 737.
[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.