Saros G B, Doolke A, Anderson R E, Jakobsson J G
Department of Anaesthesiology, Sabbatsberg Hospital, Stockholm, Sweden.
Acta Anaesthesiol Scand. 2006 May;50(5):549-52. doi: 10.1111/j.1399-6576.2006.001022.x.
Sevoflurane has become widely used in day surgery; however, desflurane may be a valuable alternative even in this setting. This study compares emergence from anaesthesia for day surgery with spontaneous breathing using either desflurane or sevoflurane.
This prospective, randomized, single-blinded study examined 70 ASA III patients undergoing elective ambulatory varicose vein surgery. Primary endpoint was emergence time (cessation of anaesthetic gas to communicating). Secondary endpoints included post-operative pain, nausea, time to discharge, and patient satisfaction. Patients were anaesthetized according to a standardized protocol including multimodal analgesia and antiemetic therapy and were randomized to receive sevoflurane or desflurane as the main anaesthetic while breathing spontaneously through a laryngeal mask airway. Fresh gas flow was oxygen in air 1 : 2 l/min.
Intra-operative anaesthesia was uneventful apart from airway irritation observed in 5/35 desflurane and 1/35 sevoflurane patients. Emergence was 25-40% faster in patients anaesthetized with desflurane. Pain and post-operative nausea and vomiting (PONV) were equally infrequent in both groups. Overall, patient satisfaction was high with no difference between the groups.
Desflurane is associated with a faster emergence with no differences during the post-operative course except a somewhat higher incidence of airway irritation.
七氟烷已广泛应用于日间手术；然而，即使在这种情况下，地氟烷也可能是一种有价值的替代药物。本研究比较了地氟烷和七氟烷用于日间手术自主呼吸麻醉后的苏醒情况。
这项前瞻性、随机、单盲研究纳入了70例接受择期门诊静脉曲张手术的美国麻醉医师协会（ASA）Ⅲ级患者。主要终点是苏醒时间（停止麻醉气体吸入至能交流的时间）。次要终点包括术后疼痛、恶心、出院时间和患者满意度。患者按照标准化方案进行麻醉，包括多模式镇痛和止吐治疗，并随机分为接受七氟烷或地氟烷作为主要麻醉药物，同时通过喉罩气道自主呼吸。新鲜气流为氧气与空气按1:2的比例，流量为1 L/min。
除了5/35例使用地氟烷和1/35例使用七氟烷的患者出现气道刺激外，术中麻醉过程平稳。使用地氟烷麻醉的患者苏醒速度快25%-40%。两组疼痛和术后恶心呕吐（PONV）的发生率相同。总体而言，患者满意度较高，两组之间无差异。
地氟烷与更快的苏醒相关，术后过程中除气道刺激发生率略高外，无其他差异。
