The comparison of effects of sevoflurane and desflurane on respiratory mechanics in smokers and nonsmokers

Abstract

In our research we aimed to evaluate effects of sevoflurane and desflurane on respiratory mechanics in smokers and nonsmokers. 100 patients who were with an age between 30 and 55 years, in ASA I-II risk group and who does not have any pulmonary diseases were participated. With using Sevoflurane and desflurane randomly in smokers and nonsmokers patient groups, 4 patient groups that each has 25 patients were constituted. After a standart anesthetic induction, desflurane of %6 and sevoflurane of %2 in O2/dry air of %50 applied for maintenance. Dynamic compliance, airway resistance and peak airway pressure of patients were recorded after induction (ind.), in the 5th (ent.5) and 25th (ent.25) after intubation. Demographic characteristics between patient groups did not differ significantly. In nonsmokers in desflurane group, airway resistance values in ent.25 (6.36±1.35) were not different than baseline value, whereas airway resistance in ent.5 (7.36±1.18.) were greater than ind. period (6.56±1.08; p<0.01). In smokers, either 5th or 25th minute values were greater than baseline value (p<0.001, p<0.01, respectively). Airway resistance (in ent.5 and ent.25) of smokers in desflurane group were greater than nonsmokers (p<0.001). In the sevoflurane group the airway resistance values at the 5th. and 25th. minutes were either in the smokers or nonsmokers lower than the baseline values (p<0.001). Values between smokers and nonsmokers did not differ from each other. Airway resistance in desflurane group were greater and compliance in desflurane group were lower than in sevoflurane group in all measurement periods except for baseline values. The changes in Dynamic compliance and peak airway pressure were compatible with the changes in the airway resistance. We found three articles who have comparised these two agents, and in two of them it is reported that sevoflurane is better than desflurane in supressing the airway responses, in the other one it was not found any difference. The effects of smoking is not studied. We found that bronchoconstriction responses to intubation in desflurane group were more severe than the responses in sevoflurane group. The responses in smokers.did not differ from nonsmokers in sevoflurane group, whereas these responses in smokers were greater than in nonsmokers in desflurane group. In conclusion we decided that; in patients, who are smokers or have an increrased bronchial hiperactivity, it would a better choise to use sevoflurane than desflurane.