Katznelson Rita, Minkovich Leonid, Friedman Zeev, Fedorko Ludvik, Beattie W Scott, Fisher Joseph A
Department of Anesthesiology, Toronto General Hospital, Eaton North 3-453, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada.
Anesth Analg. 2008 Feb;106(2):486-91, table of contents. doi: 10.1213/ane.0b013e3181602dd4.
Isocapnic hyperpnoea (IH) reduces recovery time from isoflurane anesthesia in animals and humans. We studied the effect of IH on the emergence profile of sevoflurane-anesthetized patients by comparing postoperative recovery variables in patients administered IH (IH group) to those recovered in the customary fashion (control group).
We enrolled 30 ASA I-III patients undergoing elective gynecological surgery. Induction and maintenance of anesthesia were standardized with a protocol consisting of fentanyl, propofol, rocuronium, and sevoflurane in air/O2. Patients were randomly assigned to control (C) or IH groups at the end of the surgery. We recorded time intervals from discontinuing sevoflurane to recovery milestones.
Time to tracheal extubation was much shorter in the IH group compared with group C (6.2 +/- 2.1 vs 12.3 +/- 3.8 min, respectively, P < 0.01). The IH group also had shorter times to initiation of spontaneous ventilation (4.2 +/- 1.7 vs 6.5 +/- 3.8 min, P = 0.047), eye opening (5.5 +/- 1.4 vs 13.3 +/- 4.4 min, P < 0.01), bispectral index value >75 (3.9 +/- 1.1 vs 8.8 +/- 3.7 min, P < 0.01), leaving operating room (7.7 +/- 2.0 vs 15.3 +/- 3.4 min, P < 0.01), and eligibility for postanesthetic care unit discharge (67.2 +/- 19.3 vs 90.6 +/- 20.0 min, P < 0.01).
IH accelerates recovery from sevoflurane anesthesia and shortens operating room and postanesthetic care unit stay.
等碳酸血症性通气过度(IH)可缩短动物和人类异氟烷麻醉后的恢复时间。我们通过比较接受IH治疗的患者(IH组)与以常规方式恢复的患者(对照组)的术后恢复变量,研究了IH对七氟烷麻醉患者苏醒情况的影响。
我们纳入了30例接受择期妇科手术的美国麻醉医师协会(ASA)I-III级患者。麻醉诱导和维持采用标准化方案,包括芬太尼、丙泊酚、罗库溴铵和七氟烷,吸入空气/氧气。手术结束时,患者被随机分配至对照组(C组)或IH组。我们记录了从停止使用七氟烷到恢复至各里程碑的时间间隔。
与C组相比,IH组的气管拔管时间短得多(分别为6.2±2.1分钟和12.3±3.8分钟,P<0.01)。IH组自主通气开始时间(4.2±1.7分钟对6.5±3.8分钟,P = 0.047)、睁眼时间(5.5±1.4分钟对13.3±4.4分钟,P<0.01)、脑电双频指数值>75的时间(3.9±1.1分钟对8.8±3.7分钟,P<0.01)、离开手术室时间(7.7±2.0分钟对15.3±3.4分钟,P<0.01)以及符合麻醉后护理单元出院标准的时间(67.2±19.3分钟对90.6±20.0分钟,P<0.01)也较短。
IH可加速七氟烷麻醉后的恢复,并缩短手术室停留时间和麻醉后护理单元停留时间。