Chiu C L, Chan Y K, Ong G S, Delilkan A E
Department of Anaesthesia, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
Singapore Med J. 2000 Nov;41(11):530-3.
To compare the maintenance and recovery characteristics of sevoflurane and isoflurane anaesthesia in Malaysian patients.
This is a prospective, open labelled, randomized, controlled study. Sixty unpremedicated ASA I or II patients (aged 18-50 years), scheduled for elective breast lump excision were randomly allocated to receive either isoflurane or sevoflurane for the maintenance of anaesthesia following fentanyl and propofol intravenous induction. The systolic, diastolic, mean arterial blood pressure and heart rate were measured. The speed of recovery was measured by time to eye opening, time to following simple command, and time to correctly giving own names and address. The incidence of postoperative complication was also recorded.
The trend of systolic blood pressure was significantly higher in the isoflurane group as compared to the sevoflurane group for the duration of anaesthesia (p < 0.001, by ANOVA for repeated measurement) but the trend of heart rate was similar for both groups. The recovery time was faster in the isoflurane group. [mean time of eye opening (SD) = 6.8 (2.2) vs 10.7 (4.4) min, p < 0.001; mean time of sticking tongue out (SD) = 7.9 (2.9) vs 11.5 (4.7) min, p < 0.01; mean time of giving own name (SD) = 7.8 (2.7) vs 11.8 (4.8) min, p < 0.001, mean time of giving own address (SD) = 8.4 (2.9) vs 12.0 (4.7) min, p < 0.01]. No major adverse effects were encountered postoperatively and the incidences of minor adverse effects were low in both groups.
We concluded that sevoflurane is a safe alternative to isoflurane but in these short procedures, awakening time was surprisingly slower than after isoflurane.
比较七氟烷和异氟烷麻醉在马来西亚患者中的维持和恢复特性。
这是一项前瞻性、开放标签、随机对照研究。60例未使用术前药的美国麻醉医师协会(ASA)I或II级患者(年龄18 - 50岁),计划行择期乳腺肿块切除术,在芬太尼和丙泊酚静脉诱导后,随机分配接受异氟烷或七氟烷维持麻醉。测量收缩压、舒张压、平均动脉压和心率。通过睁眼时间、对简单指令做出反应的时间、正确说出自己姓名和地址的时间来测量恢复速度。记录术后并发症的发生率。
在麻醉期间,异氟烷组的收缩压趋势显著高于七氟烷组(重复测量方差分析,p < 0.001),但两组的心率趋势相似。异氟烷组的恢复时间更快。[平均睁眼时间(标准差)= 6.8(2.2)分钟对10.7(4.4)分钟,p < 0.001;平均伸舌时间(标准差)= 7.9(2.9)分钟对11.5(4.7)分钟,p < 0.01;平均说出自己姓名的时间(标准差)= 7.8(2.7)分钟对11.8(4.8)分钟,p < 0.001,平均说出自己地址的时间(标准差)= 8.4(2.9)分钟对12.0(4.7)分钟,p < 0.01]。术后未出现重大不良反应,两组的轻微不良反应发生率均较低。
我们得出结论,七氟烷是异氟烷的一种安全替代药物,但在这些短手术中,苏醒时间比异氟烷麻醉后出人意料地更慢。