Wadhwa Anupama, Durrani Jaleel, Sengupta Papiya, Doufas Anthony G, Sessler Daniel I
Department of Anesthesiology, University of Louisville, Kentucky, USA.
Anesthesiology. 2003 Nov;99(5):1062-5. doi: 10.1097/00000542-200311000-00010.
Women generally report greater sensitivity to pain than do men, and healthy young women require 20% more anesthetic than healthy age-matched men to prevent movement in response to noxious electrical stimulation. In contrast, minimum alveolar concentration (MAC) for xenon is 26% less in elderly Japanese women than in elderly Japanese men. Whether anesthetic requirement is similar in men and women thus remains in dispute. The authors therefore tested the hypothesis that the desflurane concentration required to prevent movement in response to skin incision (MAC) differs between men and women.
Using the Dixon "up and down" method, the authors determined MAC for desflurane in 15 female and 15 male patients (18-40 yr old) undergoing surgery.
MAC was 6.2 +/- 0.4% desflurane for women versus 6.0 +/- 0.3% for men (P = 0.31), a difference of only 3%. These data provide 90% power to detect a 9% difference between the groups.
The MAC of desflurane did not differ between young men and women undergoing surgery with a true surgical incision. Although pain sensitivity may differ in women versus men, MAC of desflurane does not.
一般而言,女性报告的疼痛敏感度高于男性,并且健康的年轻女性比年龄匹配的健康男性需要多20%的麻醉剂才能防止对有害电刺激产生运动反应。相比之下,老年日本女性的氙气最低肺泡浓度(MAC)比老年日本男性低26%。因此,男女之间的麻醉需求是否相似仍存在争议。作者因此检验了以下假设:防止对皮肤切口产生运动反应所需的地氟烷浓度(MAC)在男性和女性之间存在差异。
作者采用Dixon“上下”法,测定了15例接受手术的女性患者和15例男性患者(18 - 40岁)的地氟烷MAC。
女性的地氟烷MAC为6.2±0.4%,男性为6.0±0.3%(P = 0.31),差异仅为3%。这些数据有90%的把握检测出两组之间9%的差异。
接受真正手术切口手术的年轻男性和女性之间,地氟烷的MAC没有差异。虽然女性与男性的疼痛敏感度可能不同,但地氟烷的MAC并无差异。