A Comparison of Desflurane vs. Sevoflurane Incidence and Severity of Cough

Goals for ambulatory surgery include providing optimal surgical conditions while ensuring a
rapid early recovery without side effect. Dexter et al1 concluded in a meta-analysis that
Desflurane can reduce the extubation time when compared to Sevoflurane. This potential
benefit of Desflurane can be especially attractive in short ambulatory cases performed with
general anesthesia with a laryngeal mask airway.

Although some studies have not shown a difference on perioperative cough and laryngospasm
between Desflurane and Sevoflurane at clinically relevant doses2, 3, It has been reported in
the literature that Desflurane causes cough4 and many providers avoid using Desflurane with
a laryngeal mask airway in the ambulatory setting. In this study we will also evaluate, as a
secondary outcome, the presence and severity of perioperative cough and laryngospasm.

Previous investigators have demonstrated a more rapid resumption of normal daily activities
after ambulatory surgery in patients anesthetized with Desflurane when compared with
Sevoflurane5.these investigators suggested a better quality of recovery when Desflurane is
used probably due to a lower lipid solubility of Desflurane. We will also evaluate quality
of recovery as a secondary outcome using a validated instrument6

Significance:

1. A more rapid awakening, especially, in a fast and high turnover cases that are
performed with LMA can lead to a more cost effective utilization of operating room time

2. It has been reported that Desflurane causes more cough than Sevoflurane and
Anesthesiologists avoid using Desflurane with LMA cases, this study will reinforce
that there is no difference.