A low dose of droperidol decreases the desflurane concentration needed during breast cancer surgery: a randomized double-blinded study

Abstract

Background: Droperidol (DHB) reportedly reduces the dose of propofol needed to achieve hypnosis when anesthesia is induced and decreases the bispectral index (BIS) in propofol-sedated patients during spinal anesthesia. We reported previously that supplemental DHB decreased the BIS after the administration of sevoflurane and remifentanil. This study investigated the effect of DHB on desflurane (DES) consumption in a clinical setting.

Methods: We conducted a prospective, randomized double-blinded study of 35 women with American Society of Anesthesiologist physical status I or II who underwent a mastectomy. Either DHB (20 µg/kg) or a saline placebo was administered to patients 30 min after the induction of anesthesia. A blinded anesthesiologist maintained a BIS value of 50 during anesthesia by modulating inhaled DES concentrations that changed 0.5% at 2.5 min intervals and maintained analgesia via the constant administration of remifentanil by referring to vital signs. The primary endpoint was the effect of DHB on DES consumption. The secondary endpoints included blood circulatory parameters, the time from the end of surgery to extubation, and discharge time between the groups.

Results: The characteristics of the patients did not differ between the groups. The DHB group used a mean of 27.2 ± 6.0 ml of DES compared with 41.4 ± 9.5 ml by the placebo group (P < 0.05).

Conclusions: A small dose of DHB reduced the DES concentration needed to maintain a BIS of 50. Our results show that DHB reduced the consumption of DES without adverse effects.

Keywords: Bispectral index; Desflurane; Droperidol; General anesthesia.

Fig. 1. Flow chart showing the progress of participants through the study.

Fig. 2. Changes in the dial setting of the desflurane vaporizer. The data are given as means ± SD. ^*P < 0.05 vs. the control group.

Fig. 3. Calculated volume of desflurane consumed during the observation period. The groups differed significantly. Data were expressed as median, minimum, first interquartile, third interquartile and maxium values. ^*P < 0.05.

Fig. 4. Box plot showing the time to extubation and discharge after surgery. Data were expressed as median, minimum, first interquartile, third interquartile and maxium values. The groups did not differ significantly.