Volatile anesthetics and mucociliary clearance

Background. The aim of this prospective, randomized, double blind study was to evaluate the possible modification of in vivo nasal mucociliary clearance by three different volatile agents: sevoflurane, isollurane and desflurane, following intravenous induction and tracheal intubation. Methods. Following institutional approval and informed consent, 60 patients scheduled for ear and neck surgery under general anaesthesia were randomized into three groups. Each group received sevoflurane (Group S), isoflurane (Group 1) or desflurane (Group D) at I MAC concentrations after anaesthesia induction with propofol, remifentanil and tracheal intubation with cis-atracurium. Mucociliary clearance time was assessed by in vivo saccharin transit time (STT). We recorded the time elapsed until the first recognition of sweet taste, which was taken to represent transport of saccharin to,the oropharynx. We noted the time in minutes at two time points, pre- and post-anaesthesia, under the same climatic conditions (room temperature 23 degrees C, relative humidity 60%). Results. The mean STT values after sevoflurane, isoflurane and desflurane anaesthesia were 9.1 +/- 4.3, 6.7 +/- 2.8 and 7.1 +/- 3.1 min respectively (P > 0.05). These were not significantly different among volatile anaesthetics in two measurements. Conclusion. Anaesthesia with volatile agents does not modify mucociliary clearance of nasal epithelium.