Effect of increased body mass index and anaesthetic duration on recovery of protective airway reflexes after sevoflurane vs desflurane

Abstract

Prolonged sevoflurane administration and greater BMI delay airway reflex recovery. The contribution of BMI to this delay is more pronounced after sevoflurane than desflurane.

Effects of changing from sevoflurane to desflurane on the recovery profile after sevoflurane induction: a randomized controlled study

“…Additionally, the times to orientation to the date and place were less variable in the desflurane group, suggesting that changing from sevoflurane to desflurane provides more predictable recovery compared with sevoflurane anesthesia. Patients' rapid and predictable recovery after desflurane anesthesia in our study is consistent with previous studies, 8,18 and our findings show that volatile induction with sevoflurane does not alter the favourable pharmacological characteristics of desflurane. The rapid and predictable recovery that results from changing from sevoflurane to desflurane may improve patient turnover in the operating room and may be cost-effective.…”

Postoperative recovery after anesthesia in morbidly obese patients: a systematic review and meta-analysis of randomized controlled trials

“…They determined that a longer duration of sevoflurane anesthesia significantly prolonged the airway reflex recovery time, whereas desflurane anesthesia had only a minimal effect on airway recovery time. 33 The mean BMI of patients enrolled in most of the studies in our meta-analysis ranged from 41 to 54 kgÁm -2 , and only one study enrolled patients with a mean BMI of 38.1 kgÁm -2 . 14 McKay et al showed that a longer airwayreflex recovery time in patients who were given sevoflurane was correlated with a higher BMI, whereas there was no significant correlation between the airwayreflex recovery time and BMI in patients who were given desflurane.…”

“…14 McKay et al showed that a longer airwayreflex recovery time in patients who were given sevoflurane was correlated with a higher BMI, whereas there was no significant correlation between the airwayreflex recovery time and BMI in patients who were given desflurane. 33 In addition, in a study that enrolled overweight patients undergoing minor peripheral procedures, no significant difference was observed in tracheal extubation time between the desflurane and propofol groups. 34 This might explain the nonsignificant recovery results presented in the study of Arain et al, which was the only study reporting a mean BMI of 38.1 kgÁm -2 .…”

Swallowing Impairment During Propofol Target-Controlled Infusion

“…Moreover, older age is associated with increased pharyngeal airway collapsibility during normal sleep, independent of BMI. 19 McKay et al 20 showed that a higher BMI delays airway reflex recovery after prolonged sevoflurane and desflurane administration. 21,22 Moreover, obesity is known to be associated with an increased frequency of sedation-related complications, regardless of the type of anesthetic agent used.…”