Sun R, Watcha M F, White P F, Skrivanek G D, Griffin J D, Stool L, Murphy M T
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas 75235-9068, USA.
Anesth Analg. 1999 Aug;89(2):311-6. doi: 10.1097/00000539-199908000-00012.
Methohexital is eliminated more rapidly than thiopental, and early recovery compares favorably with propofol. We designed this study to evaluate the recovery profile when methohexital was used as an alternative to propofol for the induction of anesthesia before either sevoflurane or desflurane in combination with nitrous oxide. One hundred twenty patients were assigned randomly to one of four anesthetic groups: (I) methohexital-desflurane, (II) methohexital-sevoflurane, (III) propofol-desflurane, or (IV) propofol-sevoflurane. Recovery times after the anesthetic drugs, as well as the perioperative side effect profiles, were similar in all four groups. A cost-minimization analysis revealed that methohexital was less costly for the induction of anesthesia. At the fresh gas flow rates used during this study, the costs of the volatile anesthetics for maintenance of anesthesia did not differ among the four groups. However, at low flow rates (< or = 1 L/min), the methohexital-desflurane group would have been the least expensive anesthetic technique. In conclusion, methohexital is a cost-effective alternative to propofol for the induction of anesthesia in the ambulatory setting. At low fresh gas flow rates, the methohexital-desflurane combination was the most cost-effective for the induction and maintenance of general anesthesia.
Using methohexital as an alternative to propofol for the induction of anesthesia for ambulatory surgery seems to reduce drug costs. When fresh gas flow rates < or = 1 L/min are used, the combination of methohexital for the induction and desflurane for maintenance may be the most cost-effective general anesthetic technique for ambulatory surgery.
美索比妥的消除速度比硫喷妥钠更快，早期恢复情况与丙泊酚相当。我们设计了这项研究，以评估在七氟醚或地氟醚与氧化亚氮联合使用之前，使用美索比妥替代丙泊酚进行麻醉诱导时的恢复情况。120例患者被随机分配到四个麻醉组之一：（I）美索比妥-地氟醚组，（II）美索比妥-七氟醚组，（III）丙泊酚-地氟醚组，或（IV）丙泊酚-七氟醚组。所有四组中麻醉药物后的恢复时间以及围手术期副作用情况相似。成本最小化分析显示，美索比妥用于麻醉诱导的成本更低。在本研究使用的新鲜气体流速下，维持麻醉的挥发性麻醉药成本在四组之间没有差异。然而，在低流速（≤1升/分钟）时，美索比妥-地氟醚组将是最便宜的麻醉技术。总之，在门诊手术中，美索比妥是丙泊酚用于麻醉诱导的一种具有成本效益的替代药物。在低新鲜气体流速下，美索比妥-地氟醚联合用于全身麻醉的诱导和维持是最具成本效益的。
在门诊手术中使用美索比妥替代丙泊酚进行麻醉诱导似乎可以降低药物成本。当使用的新鲜气体流速≤1升/分钟时，美索比妥诱导和地氟醚维持的联合可能是门诊手术中最具成本效益的全身麻醉技术。
