van Heerden P V, Bukofzer M, Edge K R, Morrell D F
Department of Anaesthesia, University of the Witwatersrand, Johannesburg Hospital, South Africa.
Can J Anaesth. 1992 Mar;39(3):242-6. doi: 10.1007/BF03008784.
This study was designed to determine the relative speeds of induction and complication rates using either halothane or isoflurane for rapid inhalational induction of anaesthesia. Forty ASA physical status 1 and 2, unpremedicated patients presenting for day-care dental surgery received a rapid inhalational induction (RII) with either halothane 3.5% or isoflurane 5% in humidified oxygen. The carrier gas was humidified in order to limit airway irritation caused by the pungency of the volatile agents. Isoflurane produced a faster induction than halothane-121(50) (SD) sec vs 176(36) sec (P less than 0.01). Complication rates during induction (coughing, secretions, excessive movement and abandoned inductions) were similar for the two groups. The majority of patients in both the isoflurane group (17/20) and the halothane group (14/20) found the technique of RII to be acceptable. The incidences of headache, nausea and vomiting were low and not significantly different for the two groups. Isoflurane 5% in humidified oxygen is as acceptable for RII as halothane 3.5% and has a similar complication rate. Isoflurane may be used for RII in cases where it is deemed necessary to avoid halothane, or when a more rapid inhalational induction is required than is possible with halothane. The technique of RII with either agent in unpremedicated patients is well suited to day-care anesthesia.
本研究旨在确定使用氟烷或异氟烷进行快速吸入诱导麻醉时的诱导相对速度和并发症发生率。40例美国麻醉医师协会(ASA)身体状况为1级和2级、未使用术前药的患者,因日间牙科手术前来就诊,接受了在湿化氧气中使用3.5%氟烷或5%异氟烷的快速吸入诱导(RII)。载气进行了湿化,以限制挥发性麻醉药的刺激性所引起的气道刺激。异氟烷的诱导速度比氟烷快——121(50)(标准差)秒对176(36)秒(P<0.01)。两组诱导期间的并发症发生率(咳嗽、分泌物、过度活动和诱导失败)相似。异氟烷组(17/20)和氟烷组(14/20)的大多数患者都认为RII技术是可以接受的。两组头痛、恶心和呕吐的发生率较低且无显著差异。在湿化氧气中使用5%异氟烷进行RII与使用3.5%氟烷一样可接受,且并发症发生率相似。在认为有必要避免使用氟烷的情况下,或当需要比氟烷更快的吸入诱导时,可使用异氟烷进行RII。对于未使用术前药的患者,使用这两种药物进行RII技术非常适合日间麻醉。