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Related Experiment Videos

Multicenter study of general anesthesia. II. Results.

J B Forrest1, M K Cahalan, K Rehder

  • 1Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905.

Anesthesiology
|February 1, 1990
PubMed
Summary

This clinical trial compared four anesthetics in over 17,000 patients. While major adverse events were rare, differences in outcomes like arrhythmias and recovery times were observed between enflurane, fentanyl, halothane, and isoflurane.

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Area of Science:

  • Anesthesiology
  • Clinical Pharmacology
  • Patient Safety

Background:

  • General anesthesia involves risks and potential adverse events.
  • Comparing the safety and efficacy of different anesthetic agents is crucial for clinical decision-making.
  • Previous studies have suggested varying risk profiles for common anesthetic agents.

Purpose of the Study:

  • To prospectively evaluate the safety and efficacy of four general anesthetic agents: enflurane, fentanyl, halothane, and isoflurane.
  • To identify and compare specific adverse outcomes associated with each anesthetic agent.
  • To assess the impact of these agents on patient recovery and pain management.

Main Methods:

  • Prospective, stratified, randomized clinical trial involving 17,201 patients.

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  • Patients were monitored before, during, and up to 7 days after anesthesia.
  • Adverse outcomes, including mortality, myocardial infarction, stroke, arrhythmias, and recovery parameters, were recorded and analyzed.

    • Main Results:

    • Overall mortality was low (0.11%), with anesthesia potentially contributing in 0.04% of deaths.
    • No significant differences were found in rates of death, myocardial infarction, or stroke among the agents.
    • Significant differences in adverse events included higher rates of severe ventricular arrhythmia with halothane, severe hypertension and bronchospasm with fentanyl, and severe tachycardia with isoflurane.
    • Recovery was slowest with halothane, while fentanyl use was associated with less pain in the recovery room.

    Conclusions:

    • Clinically significant differences exist among enflurane, fentanyl, halothane, and isoflurane regarding specific adverse outcomes and recovery.
    • Halothane was associated with slower recovery and more ventricular arrhythmias.
    • Fentanyl was linked to less pain but more hypertension and bronchospasm, while isoflurane showed higher rates of tachycardia.