Impact of short-acting vs. standard anaesthetic agents on obstructive sleep apnoea: a randomised, controlled, triple-blind trial.

Details

Serval ID
serval:BIB_02558144D0F9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of short-acting vs. standard anaesthetic agents on obstructive sleep apnoea: a randomised, controlled, triple-blind trial.
Journal
Anaesthesia
Author(s)
Albrecht E., Bayon V., Hirotsu C., Heinzer R.
ISSN
1365-2044 (Electronic)
ISSN-L
0003-2409
Publication state
Published
Issued date
01/2021
Peer-reviewed
Oui
Volume
76
Number
1
Pages
45-53
Language
english
Notes
Publication types: Journal Article ; Randomized Controlled Trial
Publication Status: ppublish
Abstract
Sleep apnoea is associated with negative outcomes following general anaesthesia. Current recommendations suggest using short-acting anaesthetic agents in preference to standard agents to reduce this risk, but there is currently no evidence to support this. This randomised controlled triple-blind trial tested the hypothesis that a combination of short-acting agents (desflurane-remifentanil) would reduce the postoperative impact of general anaesthesia on sleep apnoea severity compared with standard agents (sevoflurane-fentanyl). Sixty patients undergoing hip arthroplasty under general anaesthesia were randomised to anaesthesia with desflurane-remifentanil or sevoflurane-fentanyl. Respiratory polygraphy was performed before surgery and on the first and third postoperative nights. The primary outcome was the supine apnoea-hypopnoea index on the first postoperative night. Secondary outcomes were the supine apnoea-hypopnoea index on the third postoperative night, and the oxygen desaturation index on the first and third postoperative nights. Additional outcomes included intravenous morphine equivalent consumption and pain scores on postoperative days 1, 2 and 3. Pre-operative sleep study data were similar between groups. Mean (95%CI) values for the supine apnoea-hypopnoea index on the first postoperative night were 18.9 (12.7-25.0) and 21.4 (14.2-28.7) events.h <sup>-1</sup> , respectively, in the short-acting and standard anaesthesia groups (p = 0.64). Corresponding values on the third postoperative night were 28.1 (15.8-40.3) and 38.0 (18.3-57.6) events.h <sup>-1</sup> (p = 0.34). Secondary sleep- and pain-related outcomes were generally similar in the two groups. In conclusion, short-acting anaesthetic agents did not reduce the impact of general anaesthesia on sleep apnoea severity compared with standard agents. These data should prompt an update of current recommendations.
Keywords
Adult, Aged, Aged, 80 and over, Anesthesia, General/methods, Anesthetics, Inhalation, Anesthetics, Intravenous, Arthroplasty, Replacement, Hip, Desflurane, Double-Blind Method, Female, Fentanyl, Humans, Male, Middle Aged, Oxygen/blood, Pain, Postoperative/epidemiology, Postoperative Complications/physiopathology, Postoperative Complications/prevention & control, Remifentanil, Sevoflurane, Sleep Apnea, Obstructive/complications, Sleep Apnea, Obstructive/physiopathology, Sleep Apnea, Obstructive/prevention & control, Supine Position, Treatment Outcome, anaesthesia, hip arthroplasty, perioperative medicine, sleep apnoea
Pubmed
Web of science
Open Access
Yes
Funding(s)
Swiss National Science Foundation / Projects / 32003B_169974
Create date
07/12/2020 15:48
Last modification date
20/01/2021 7:24
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