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 CO₂, 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% O₂-50% air). Hemodynamic and respiratory parameters (HR, MAP, SpO₂, EtCO₂) will be recorded at predefined time points, along with arterial blood gas analysis (pH, pCO₂, pO₂, 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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
40
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).
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).
Veli Fahri Pehlivan
Sanliurfa, Turkey (Türkiye)
RECRUITINGChange 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.
Time frame: 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.
Time frame: From preoperative baseline to 120 minutes after induction
Change in End-Tidal CO₂
End-tidal carbon dioxide (EtCO₂) levels will be monitored during surgery at specified intervals.
Time frame: From preoperative baseline to 120 minutes after induction
Change in Peripheral Oxygen Saturation
Peripheral oxygen saturation (SpO₂) will be measured at baseline, post-intubation, and intraoperative time points.
Time frame: From preoperative baseline to 120 minutes after induction
Change in Arterial pH
Arterial blood gas samples will be analyzed for pH at baseline, 60 and 120 minutes, and at end of surgery.
Time frame: Preoperative, intraoperative (60 and 120 min), end of surgery
Post-Anesthesia Recovery Times
Time to return of spontaneous respiration, time to extubation, and time to follow verbal commands will be recorded.
Time frame: From end of surgery until recovery (within approx. 30 minutes)
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