Comparison of the Effects of Desflurane and Sevoflurane on Middle Ear Pressure: A Randomized Controlled Clinical Trial

Abstract

Objective: The aim of the present study was to compare the effects of two inhalation anesthetics, desflurane and sevoflurane, on middle ear pressure. Methods: After we obtained written consent from the patients and the approval from our institutional ethical committee, we included 56 ASA I-II patients aged between 18 and 60 years in this study. They were randomly divided into two groups of 28 patients each. Desflurane 4-6% (Group D) or sevoflurane 1-2% (Group S) were used for anesthesia management in patients. Baseline tympanometry was carried out and recorded before the induction of anesthesia on both ears, and 3 more measurements were done and recorded 5, 15 and 30 min after induction. Results: In both groups, middle ear pressure values were found to be significantly elevated when compared to baseline measurements (p < 0.05). When middle ear pressure was compared between the groups, no difference was found between the values obtained at baseline and at 5 min in Group S, while especially the values obtained at 15 min revealed significantly higher middle ear pressures in Group D. Conclusion: It was observed that the increase in middle ear pressure caused by sevoflurane was significantly lower than that caused by desflurane.

Acute Intraoperative Tympanic Membrane Rupture in Patient Anesthetized With Desflurane Without Nitrous Oxide: A Case Report

“…Evidence supports this notion; desflurane increases MEP to a greater extent than either sevoflurane or isoflurane. 6,7,9,10 All 3 of these modern agents have a less pronounced increase in MEP compared to N 2 O. Normal MEP for adults has been shown to be ± 7.5 mm Hg while TM rupture is known to occur at an average MEP of 290 mm Hg.…”