2019 Volume 39 Issue 1 Pages 1-8
Some randomized controlled trials have shown that patients awaken sooner when anesthetized with desflurane than with sevoflurane. However, studies comparing desflurane and sevoflurane have not considered the possibility that the time to awakening is affected by the proficiency of anesthesiologists. We examined whether the time to extubation is more affected by the proficiency of the anesthesiologist than by the type of volatile anesthetic.
We performed a retrospective cohort study. Eligible subjects were patients who required volatile anesthesia. The primary outcome was the time to extubation. The Cox proportional hazard model was used to derive factors affecting the primary outcome. We analyzed data from 1,398 patients. Cox proportional hazard analysis showed that the use of desflurane was associated with time to extubation（Hazard ratio ［HR］, 1.17；95% confidence interval, 1.01-1.34；p=0.040）. However, time to extubation was more associated with whether the anesthesiologist in charge was a junior resident or a senior member of the staff than with the use of desflurane（junior resident；reference, post graduate year 10 and more；HR 1.53, 1.20-1.97, p=0.001）. Our study suggests that time to extubation is more affected by the proficiency of the anesthesiologist than by the type of volatile anesthetic used.
