Rocca G, Montecchi C, Baisi F, Monaco S, Romboli D, Gasparetto A
Istituto di Anestesiologia e Rianimazione, Azienda Ospedaliera Policlinico Umberto I, Università degli Studi di Roma, La Sapienza.
Minerva Anestesiol. 2000 Sep;66(9):611-9.
The characteristics of sevoflurane make it able to be used without N2O avoiding its undesirable effects to this associates. The aim of the study is to evaluate the clinical characteristics of sevoflurane anesthesia "N2O free" in comparison to sevoflurane anesthesia with N2O.
920 patient undergoing elective surgery in 12 centers were included in this study. All the patients were monitored with routine monitoring. The patients were randomized in two groups: group Air in which the anesthesia was maintained with sevoflurane in Air:O2; group N2O in which the anesthesia was maintained with sevoflurane in N2O:O2. Opioids were administered as necessary (changes of the heart rate and/or of the arterial pressure > 20% in comparison to the baseline values). For each patient we evaluated the consumption of opioids, the time from discontinuation of the sevoflurane and the extubation and full recovery, defined as presence of a complete cognitive function; the quality of awakening, the incidence of postoperative nausea and vomiting (PONV) and the quality of postoperative analgesia.
We didn't observe differences between the two groups. In conclusions, omitting N2O during sevoflurane anesthesia can be considered a safe technique, avoiding the acute and chronic side effects associated with the use of N2O, without modifying the intraop consumption of opioid, the recovery and the early postoperative incidence of nausea, vomiting and analgesia.
七氟醚的特性使其能够在不使用氧化亚氮(N2O)的情况下使用,从而避免其对相关人员产生不良影响。本研究的目的是评估与使用N2O的七氟醚麻醉相比,“无N2O”七氟醚麻醉的临床特征。
本研究纳入了12个中心的920例接受择期手术的患者。所有患者均进行常规监测。患者被随机分为两组:空气组,麻醉维持采用七氟醚与空气:氧气混合;N2O组,麻醉维持采用七氟醚与N2O:氧气混合。必要时给予阿片类药物(心率和/或动脉压较基线值变化>20%)。对每位患者,我们评估了阿片类药物的消耗量、停止使用七氟醚至拔管和完全恢复的时间(完全恢复定义为具有完整的认知功能)、苏醒质量、术后恶心呕吐(PONV)的发生率以及术后镇痛质量。
我们未观察到两组之间存在差异。总之,在七氟醚麻醉期间省略N2O可被视为一种安全技术,可避免与使用N2O相关的急性和慢性副作用,同时不改变术中阿片类药物的消耗量、恢复情况以及术后早期恶心、呕吐和镇痛的发生率。