Camci Emre, Koltka Kemalettin, Celenk Yasemin, Tugrul Mehmet, Pembeci Kamil
Department of Anesthesiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
J Anesth. 2006;20(2):149-52. doi: 10.1007/s00540-005-0376-3.
In this prospective, randomized study we compared the recovery profiles of bispectral index (BIS)-guided anesthesia regimens with desflurane or propofol in ambulatory arthroscopy. Fifty ASA I-II adult patients who underwent knee arthroscopy were randomized to receive desflurane (D) or propofol (P) infusion accompanied by remifentanil and nitrous oxide during maintenance, titrated to maintain a bispectral index value between 50 and 60. Initial awakening, fast-track eligibility, and home readiness as well as intraoperative hemodynamics, were compared. The groups did not differ with respect to demographics, duration of operation, or intraoperative vital signs. Although the times for initial awakening parameters were shorter in group D, the differences between the groups were not significant. The time needed for the White fast-track score to reach 12 was shorter in group P than group D (9 +/- 3.5 min vs 12.5 +/- 5.3 min). However, home readiness did not differ significantly between the groups. Desflurane is an alternative to propofol for BIS-guided ambulatory anesthesia. Using desflurane in combination with opioid analgesics blunted its rapid emergence characteristics, and the higher frequency of emetic symptoms with desflurane diminished the success of its fast-track eligibility.
在这项前瞻性随机研究中，我们比较了在门诊关节镜检查中，双谱指数（BIS）引导下使用地氟烷或丙泊酚麻醉方案的恢复情况。五十例接受膝关节镜检查的美国麻醉医师协会（ASA）I-II级成年患者被随机分为两组，分别在维持麻醉期间接受地氟烷（D）或丙泊酚（P）输注，并同时使用瑞芬太尼和氧化亚氮，通过滴定使双谱指数值维持在50至60之间。比较了两组患者的初始苏醒情况、快速康复适宜性、回家准备情况以及术中血流动力学。两组患者在人口统计学特征、手术时长或术中生命体征方面无差异。尽管D组的初始苏醒参数时间较短，但两组之间的差异并不显著。P组达到怀特快速康复评分12所需的时间比D组短（9±3.5分钟 vs 12.5±5.3分钟）。然而，两组患者的回家准备情况差异不显著。在地氟烷用于BIS引导的门诊麻醉时，地氟烷可作为丙泊酚的替代药物。将地氟烷与阿片类镇痛药联合使用会削弱其快速苏醒的特性，并且地氟烷引起呕吐症状的频率较高，降低了其快速康复适宜性的成功率。
