Desflurane Versus Isoflurane for Speeding Postanesthetic Recovery and Hospital Discharge

Desflurane Versus Isoflurane for Speeding Postanesthetic Recovery and Hospital Discharge: a Cluster Randomized Crossover Trial

The investigators thus propose a comparative effectiveness quality improvement project to evaluate the feasibility of switching from near-exclusive use of isoflurane in adult general surgical patients to Desflurane.

Study Overview

• Status: Withdrawn
• Conditions: Surgery
• Intervention / Treatment: Drug: Desflurane; Drug: Isoflurane

Detailed Description

The three available volatile anesthetics appear to be comparably safe. However, higher solubility slows emergence from isoflurane and sevoflurane compared to Desflurane. Even a few minutes delay in emergence from anesthesia has financial implications since institutional costs of operating room time can easily be $30 per minute. Postoperative care is also expensive. Furthermore, in busy hospitals such as the Cleveland Clinic, inadequate recovery throughput frequently delays surgery.

The investigators thus propose a comparative effectiveness quality improvement project to evaluate the feasibility of switching from near-exclusive use of isoflurane in adult general surgical patients to Desflurane. (The investigators will exclude children because there are compelling clinical reasons to use sevoflurane in pediatric patients.) The proposed comparison is between isoflurane (our current routine) and Desflurane which is no longer used at the Clinic because of price concerns - a decision that that did not consider down-stream effects, including prolonged emergence and recovery.

• Study Type: Interventional
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Ohio
    • Cleveland, Ohio, United States, 44195
      • Cleveland Clinic

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adults having general anesthesia in the G operating room suite at the Cleveland Clinic Main Campus.

Exclusion Criteria:

• Operations lasting <1.5 hours.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Desflurane; General anesthesia with desflurane.	Drug: Desflurane; General anesthesia with desflurlane
Experimental: Isoflurane; General anesthesia with isoflurane.	Drug: Isoflurane; General anesthesia with isoflurane

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Duration of post-anesthesia care unit recovery	Time from entry to the post-anesthesia to discharge from unit.	1 hour

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Duration of anesthetic emergence	Time from a MAC fraction of 0.3 (presumably shortly after volatile anesthesia is discontinued) and extubation.	1 hour
Cost of post-anesthesia care unit.	Cost of post-anesthesia unit care. To be estimated only if there is a substantial difference between the groups.	2 hours
Delirium	Incidence of postoperative delirium.	5 days

Collaborators and Investigators

• Sponsor: The Cleveland Clinic
• Investigators: Principal Investigator: Allen Keebler, D.O., The Cleveland Clinic

Study record dates

Study Major Dates

• Study Start (Actual): December 8, 2023
• Primary Completion (Actual): March 2, 2026
• Study Completion (Actual): March 2, 2026

Study Registration Dates

• First Submitted: January 22, 2024
• First Submitted That Met QC Criteria: February 7, 2024
• First Posted (Actual): February 9, 2024

Study Record Updates

• Last Update Posted (Actual): March 5, 2026
• Last Update Submitted That Met QC Criteria: March 3, 2026
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Organic Chemicals; Ethers; Hydrocarbons; Hydrocarbons, Halogenated; Hydrocarbons, Fluorinated; Methyl Ethers; Ethyl Ethers; Desflurane; Isoflurane
• Other Study ID Numbers: 23-1049

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No