De Baerdemaeker Luc E C, Jacobs Stefan, Den Blauwen Nadia M M, Pattyn Piet, Herregods Luc L G, Mortier Eric P, Struys Michel M R F
Ghent University Hospital, Gent, Belgium.
Obes Surg. 2006 Jun;16(6):728-33. doi: 10.1381/096089206777346691.
This randomized prospective study with blinded postanesthesia care unit (PACU) observers compared the recovery profiles in morbidly obese patients who received sevoflurane or desflurane for maintenance of anesthesia in combination with a remifentanil target controlled infusion (TCI).
50 morbidly obese patients scheduled for laparoscopic gastric banding were included to receive BIS-guided sevoflurane or desflurane anesthesia with BIS-triggered inhalation boli in combination with remifentanil TCI. In the PACU, the following recovery scores were investigated: Modified Aldrete score, a modified Observers' Assessment of Alertness/Sedation Scale (OAA/S), pain numerical rating scale (NRS), oxygen saturation (SpO(2)) and postoperative nausea and vomiting (PONV).
OAA/S and NRS pain scores showed a similar evolution in both groups from the moment of PACU admission up to 120 minutes after admission. In both groups, patients showed no serious hypoxemia during PACU stay. Incidence of PONV was shorter lasting in the sevoflurane group compared to the desflurane group.
No clinically relevant difference was found in recovery in the PACU between morbidly obese patients anesthetized with desflurane or sevoflurane. Both agents resulted in satisfactory recovery in morbidly obese patients.
这项随机前瞻性研究中，麻醉后监护病房（PACU）的观察者采用盲法，比较了接受七氟醚或地氟醚维持麻醉并联合瑞芬太尼靶控输注（TCI）的病态肥胖患者的恢复情况。
纳入50例计划行腹腔镜胃束带术的病态肥胖患者，接受脑电双频指数（BIS）引导下的七氟醚或地氟醚麻醉，并通过BIS触发吸入剂量，联合瑞芬太尼TCI。在PACU中，研究以下恢复评分：改良Aldrete评分、改良的观察者警觉/镇静评估量表（OAA/S）、疼痛数字评分量表（NRS）、血氧饱和度（SpO₂）以及术后恶心呕吐（PONV）情况。
从进入PACU时刻至进入后120分钟，两组患者的OAA/S和NRS疼痛评分变化相似。两组患者在PACU停留期间均未出现严重低氧血症。与地氟醚组相比，七氟醚组PONV的持续时间更短。
在PACU中，接受地氟醚或七氟醚麻醉的病态肥胖患者的恢复情况未发现临床相关差异。两种药物均使病态肥胖患者获得了满意的恢复效果。
