Retrospective Investigation of Perioperative Upper Airway Complications after Anesthesia using Supraglottic Airway Devices in Children: Comparison of Desflurane and Sevoflurane

Abstract

Background : Desflurane is known to be the most pungent of the currently used volatile anaesthetics. We aimed to assess wehether desflurane increases the incidence of perioperative upper airway complications in infants and children undergoing general anaesthesia using supraglottic airway devices compared with sevoflurane. Methods : We retrospectively reviewed and analysed the electrical medical records of consecutive children aged 15 years or younger who underwent general anaesthesia under supraglottic airway devices using sevoflurane or desflurane as maintenance agents at Seoul National University Bundang Hospital between June 2013 and June 2015. Results : In total, 3,511 patients were evaluated. The incidence of upper airway events was 0.46% (13/2,831) in patients maintained with sevoflurane and 0.74% (5/680) in those maintained with desflurane (P = 0.370). In a logistic regression model, after controlling for the effect of American Society of Anesthesiologist (ASA) class, the type and size of the supraglottic airways, as well as the type of surgery, the adjusted odds ratio was 0.99 (0.31-3.14), and there was no significant difference between sevoflurane and desflurane. Conclusions : The incidence of perioperative upper airway complications after anaesthesia using supraglottic airway devices in children was not significantly different between sevoflurane and desflurane used as maintenance agents in infants and children.