• Eun-Hee Kim, In-Kyung Song, Ji-Hyun Lee, Hee-Soo Kim, Hyun-Chang Kim, Soo-Hyuk Yoon, Young-Eun Jang, and Jin-Tae Kim.
• aDepartment of Anesthesiology and Pain Medicine, Seoul National University Hospital, Jongno-gu bDepartment of Anaesthesiology and Pain Medicine, Asan Medical Center, Ulsan College of Medicine, Songpa-GU, Seoul cDepartment of Anesthesiology and Pain Medicine, Keimyung University Dongsan Medical Center, Jung-gu, Daegu, Republic of Korea.
• Medicine (Baltimore). 2017 Sep 1; 96 (35): e7977.

BackgroundDesflurane with a laryngeal mask airway may have advantages during ambulatory anesthesia. However, desflurane-induced airway irritability makes the use of desflurane challenging, especially in children. This study compared desflurane with sevoflurane maintenance anesthesia in terms of respiratory events and the emergence characteristics in children with a laryngeal mask airway.MethodsThis randomized controlled trial evaluated 200 children undergoing strabismus surgery allocated to desflurane or sevoflurane groups. After inducing anesthesia with sevoflurane and thiopental sodium 5 mg kg, the anesthetic agent was changed to desflurane in the desflurane group, whereas sevoflurane was continued in the sevoflurane group. Respiratory events, emergence time, recovery time, and emergence agitation were compared between the groups.ResultsThe overall respiratory events did not differ between the groups. However, the incidence of mild desaturation (90% ≤ SpO2 < 97%) was significantly higher in the desflurane group (7%) than in the sevoflurane group (0%) (P = .007). Emergence was significantly faster in the desflurane group (6.6 ± 3.9 vs 8.0 ± 2.2 min, P = .003). The recovery time and emergence agitation in the postanesthesia care unit were comparable between groups. Laryngospasm developed in 5 children (1 in the sevoflurane group and 4 in the desflurane group, P = .365); of these, 4 patients were younger than 3 years.ConclusionDesflurane maintenance anesthesia in children with a laryngeal mask airway shows a similar rate of overall respiratory events compared with sevoflurane anesthesia. However, anesthesiologists should be cautious of using desflurane in younger children concerning desaturation events during emergence.

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