Sinclair David R, Chung Frances, Smiley Alison
Department of Anesthesiology, University of Florida, Jacksonville, USA.
Can J Anaesth. 2003 Mar;50(3):238-45. doi: 10.1007/BF03017791.
The current recommendations to refrain from driving for 24 hr after general anesthesia (GA) lack evidence. Our objective was to measure impairment of driving performance at various time intervals after anesthesia using driving impairment at different blood alcohol concentrations (BAC) as a gold standard for comparison.
Institutional Review Board approval was obtained. A cross-over design, within subject comparison was used. Twelve volunteers were randomized to three treatments: GA, alcohol, and no drug. Psychomotor recovery was assessed by Digit Symbol Substitution Test (DSST) and Trieger Dot Test (TDT). On the anesthetic day, GA was induced with propofol 2.5 mg x kg(-1) and fentanyl l micro g x kg(-1) and maintained with N(2)O-O(2) 50:50 and approximately one minimum alveolar concentration of desflurane by spontaneous ventilation for 30 min. Driving simulator test runs occurred at two, three, four, and 24 hr postanesthesia. On the alcohol treatment day, a vodka and orange juice beverage was administered to reach the legal limit for BAC in the province of Ontario, Canada (BAC 0.08%). On the control day, no drug was given. Driving simulator test runs corresponded to the same time of day as the postanesthetic test runs. Two-way analysis of variance for dependent samples (ANOVA) was performed using the SAS program. P values of less than 0.05 were considered significant.
There was no significant difference in postanesthetic driving skills at two, three, and four hours postanesthesia, and the corresponding control sessions. There was no significant difference among the three sessions with respect to pen and paper tests of psychomotor performance. Performance during the alcohol session differed significantly from that during the control and postanesthetic sessions.
Certain driving skills return by two hours after one half hour of GA of propofol, desflurane, and fentanyl in a group of young volunteers.
目前关于全身麻醉（GA）后24小时内避免驾驶的建议缺乏证据。我们的目标是通过将不同血液酒精浓度（BAC）下的驾驶能力受损情况作为比较的金标准，来测量麻醉后不同时间间隔的驾驶性能损害。
获得了机构审查委员会的批准。采用交叉设计，进行受试者内比较。12名志愿者被随机分为三种处理：全身麻醉、酒精和无药物。通过数字符号替换测试（DSST）和特里格点测试（TDT）评估精神运动恢复情况。在麻醉日，用2.5 mg·kg⁻¹丙泊酚和1 μg·kg⁻¹芬太尼诱导全身麻醉，并通过自主通气以50:50的N₂O - O₂和大约一个最低肺泡浓度的地氟醚维持30分钟。在麻醉后2、3、4和24小时进行驾驶模拟器测试。在酒精处理日，给予伏特加和橙汁饮料以达到加拿大安大略省BAC的法定限值（BAC 0.08%）。在对照日，不给予药物。驾驶模拟器测试与麻醉后测试在同一天的相同时间进行。使用SAS程序进行相关样本的双向方差分析（ANOVA）。P值小于0.05被认为具有统计学意义。
麻醉后2、3和4小时的驾驶技能与相应的对照时段相比无显著差异。在精神运动性能的纸笔测试方面，三个时段之间无显著差异。酒精时段的表现与对照时段和麻醉后时段的表现有显著差异。
在一组年轻志愿者中，使用丙泊酚、地氟醚和芬太尼进行半小时全身麻醉后两小时，某些驾驶技能得以恢复。
