Boisson-Bertrand D, Laxenaire M C, Mertes P M
Department ofAnaesthesia and Intensive Care, University Hospital of Nancy, France.
Anaesth Intensive Care. 2006 Jun;34(3):338-42. doi: 10.1177/0310057X0603400302.
In this study, 33 patients were randomly assigned to receive desflurane (D) or isoflurane (I) for acoustic neuroma surgery. The time from end of the procedure to spontaneous breathing, extubation, eye-opening, hand-squeezing to command, and ability to state name, birthdate and phone number were recorded. The Steward recovery score was also recorded every five minutes during the first 20 minutes postoperatively and then every 10 to 15 minutes. Groups were similar regarding patient characteristics, depth of anaesthesia, sufentanil total dose, anaesthesia duration (D: 349.1 +/- 19.1 min; I: 349.2 +/- 22.9 min), haemodynamic/respiratory parameters, and surgical conditions (assessed by a bleeding score). The emergence time in the D group was significantly faster than the I group (D: 14.9 +/- 2.4 min vs I: 29.2 +/- 2.4 min for eye-opening). Full recovery also occurred earlier in the D group (D: 22.1 +/- 3.1 min vs I: 37.6 +/- 4.0 min, P<0.005 for stating name). Steward recovery scores were also better during the first postoperative hour in the D group (D: 40 min vs I: 90 min, P<0.005 for 100% of patients with Steward score of 6). The results indicate that desflurane is associated with similar operating conditions and faster postoperative recovery following acoustic neuroma surgery. The faster recovery following desflurane may be desirable after long surgical procedures, enabling the patient's full cooperation and facilitating early diagnosis of any potential neurological deficit.
在本研究中，33例患者被随机分配接受地氟醚（D）或异氟醚（I）用于听神经瘤手术。记录从手术结束到自主呼吸、拔管、睁眼、按指令捏手以及说出姓名、出生日期和电话号码的时间。术后前20分钟每5分钟记录一次Steward恢复评分，然后每10至15分钟记录一次。两组在患者特征、麻醉深度、舒芬太尼总剂量、麻醉持续时间（D组：349.1±19.1分钟；I组：349.2±22.9分钟）、血流动力学/呼吸参数以及手术情况（通过出血评分评估）方面相似。D组的苏醒时间明显快于I组（睁眼时间：D组14.9±2.4分钟 vs I组29.2±2.4分钟）。D组的完全恢复也更早（说出姓名时间：D组22.1±3.1分钟 vs I组37.6±4.0分钟，P<0.005）。术后第一小时内D组的Steward恢复评分也更好（Steward评分为6分的患者达到100%时，D组为40分钟 vs I组为90分钟，P<0.005）。结果表明，地氟醚在听神经瘤手术后具有相似的手术条件且术后恢复更快。长时间手术后，地氟醚更快的恢复可能是理想的，能使患者充分配合并便于早期诊断任何潜在的神经功能缺损。
