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This randomized, double-blind, controlled clinical trial aims to compare the effects of low-flow sevoflurane and desflurane anesthesia on physiological parameters and recovery profiles in adult patients undergoing ENT surgeries. The primary outcomes include heart rate, mean arterial pressure, peripheral oxygen saturation, end-tidal COâ‚‚, and arterial blood gas values. Secondary outcomes involve time to spontaneous respiration, extubation, and response to verbal commands.
This prospective study investigates the clinical effects of low-flow anesthesia using two commonly utilized volatile agents, sevoflurane and desflurane, in adult patients undergoing elective ENT surgeries, specifically rhinoplasty, mastoidectomy, and tympanoplasty. A total of 40 ASA I-II patients, aged 18-65, will be randomly assigned into two groups: Group S (sevoflurane) and Group D (desflurane).
All participants will undergo general anesthesia with endotracheal intubation. After 2 minutes of preoxygenation with 100% oxygen at 10 L/min, anesthesia will be induced and maintained with the assigned volatile agent under low-flow settings (1 L/min, 50% Oâ‚‚-50% air). Hemodynamic and respiratory parameters (HR, MAP, SpOâ‚‚, EtCOâ‚‚) will be recorded at predefined time points, along with arterial blood gas analysis (pH, pCOâ‚‚, pOâ‚‚, COHb).
Recovery times including return of spontaneous respiration, extubation, and verbal response will be documented. This study aims to provide clinical evidence on the optimal anesthetic choice under low-flow conditions, supporting safer, more efficient, and environmentally conscious anesthesia practices.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sevoflurane Low-Flow Anesthesia | Experimental | Participants in this group will receive general anesthesia using sevoflurane administered under low-flow conditions. After standard induction and intubation, sevoflurane will be maintained at 2-3% (0.8-1 MAC) with a fresh gas flow of 1 L/min (50% oxygen / 50% air). Vital signs and arterial blood gases will be monitored, and recovery parameters such as time to spontaneous breathing, extubation, and verbal response will be recorded. |
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| Desflurane Low-Flow Anesthesia | Active Comparator | Participants in this group will receive general anesthesia using desflurane administered under low-flow conditions. After standard induction and intubation, desflurane will be maintained at 4-6% (0.8-1 MAC) with a fresh gas flow of 1 L/min (50% oxygen / 50% air). Hemodynamic and respiratory parameters as well as arterial blood gases and recovery times will be evaluated and compared to the sevoflurane group. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sevoflurane | Drug | Sevoflurane will be administered via inhalation under low-flow anesthesia conditions. The concentration will be maintained at 2-3% (0.8-1 MAC) with a fresh gas flow of 1 L/min (50% oxygen and 50% air) after induction. Used in Group S (Sevoflurane Low-Flow Anesthesia Arm). |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Heart Rate During Surgery | Heart rate (HR) will be measured at baseline, post-intubation, and at 15, 30, 45, 60, and 120 minutes after anesthesia induction. | From preoperative baseline to 120 minutes after anesthesia induction |
| Change in Mean Arterial Pressure During Surgery | Mean arterial pressure (MAP) will be recorded at the same predefined time intervals during surgery. | From preoperative baseline to 120 minutes after induction |
| Change in End-Tidal COâ‚‚ | End-tidal carbon dioxide (EtCOâ‚‚) levels will be monitored during surgery at specified intervals. | From preoperative baseline to 120 minutes after induction |
| Change in Peripheral Oxygen Saturation | Peripheral oxygen saturation (SpOâ‚‚) will be measured at baseline, post-intubation, and intraoperative time points. | From preoperative baseline to 120 minutes after induction |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Arterial pH | Arterial blood gas samples will be analyzed for pH at baseline, 60 and 120 minutes, and at end of surgery. | Preoperative, intraoperative (60 and 120 min), end of surgery |
| Post-Anesthesia Recovery Times |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Basak Pehlivan, Asoc Prof. Dr | Harran University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Veli Fahri Pehlivan | Sanliurfa | 63100 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D000077149 | Sevoflurane |
| D000077335 | Desflurane |
| ID | Term |
|---|---|
| D008738 | Methyl Ethers |
| D004987 | Ethers |
| D009930 | Organic Chemicals |
| D006845 | Hydrocarbons, Fluorinated |
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Participants will be randomly assigned to receive either low-flow sevoflurane or low-flow desflurane anesthesia.
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Both participants and outcome assessors will be blinded to group allocation. Anesthesia providers will use coded gas assignments to ensure blinding during the intervention.
|
| Desflurane | Drug | Desflurane will be administered via inhalation under low-flow anesthesia conditions. The concentration will be maintained at 4-6% (0.8-1 MAC) with a fresh gas flow of 1 L/min (50% oxygen and 50% air) after induction. Used in Group D (Desflurane Low-Flow Anesthesia Arm). |
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Time to return of spontaneous respiration, time to extubation, and time to follow verbal commands will be recorded.
| From end of surgery until recovery (within approx. 30 minutes) |
| D006846 |
| Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D005019 | Ethyl Ethers |