Iwata T, Inoue S, Kawaguchi M, Takahashi M, Sakamoto T, Kitaguchi K, Furuya H, Sakaki T
Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
Br J Anaesth. 2003 Jan;90(1):32-8.
Because the time available for cooling and rewarming during deliberate mild hypothermia is limited, studies of the rate of the cooling and rewarming are useful. The decrease in core hypothermia caused by heat redistribution depends on the anaesthetic agent used. We therefore investigated possible differences between sevoflurane and propofol on the decrease and recovery of core temperature during deliberate mild hypothermia for neurosurgery.
After institutional approval and informed consent, 26 patients were assigned randomly to maintenance of anaesthesia with propofol or sevoflurane. Patients in the propofol group (n=13) received propofol induction followed by a continuous infusion of propofol 3-5 mg kg(-1) h(-1). Patients in the sevoflurane group (n=13) received propofol induction followed by sevoflurane 1-2%. Nitrous oxide and fentanyl were also used for anaesthetic maintenance. After induction of anaesthesia, patients were cooled and tympanic membrane temperature was maintained at 34.5 degrees C. After surgery, patients were actively rewarmed.
There was no difference in the rate of decrease and recovery of core temperature between the groups. There was also no difference in skin surface temperature gradient (forearm to fingertip), heart rate and mean arterial blood pressure between the groups.
Sevoflurane-based anaesthesia did not affect cooling and rewarming for deliberate mild hypothermia compared with propofol-based anaesthesia.
由于在控制性轻度低温期间可用于降温及复温的时间有限，因此对降温和复温速率的研究很有必要。由热再分布引起的核心体温降低取决于所使用的麻醉剂。因此，我们研究了在神经外科手术控制性轻度低温期间，七氟醚和丙泊酚在核心体温降低及恢复方面可能存在的差异。
经机构批准并获得知情同意后，将26例患者随机分配至丙泊酚或七氟醚麻醉维持组。丙泊酚组（n = 13）患者先接受丙泊酚诱导，随后持续输注丙泊酚3 - 5 mg·kg⁻¹·h⁻¹。七氟醚组（n = 13）患者先接受丙泊酚诱导，随后吸入1 - 2%的七氟醚。氧化亚氮和芬太尼也用于麻醉维持。麻醉诱导后，对患者进行降温，使鼓膜温度维持在34.5℃。术后，对患者进行积极复温。
两组间核心体温降低及恢复的速率无差异。两组间皮肤表面温度梯度（前臂至指尖）、心率及平均动脉血压也无差异。
与丙泊酚麻醉相比，七氟醚麻醉对控制性轻度低温的降温和复温无影响。
