Fletcher J E, Sebel P S, Murphy M R, Smith C A, Mick S A, Flister M P
Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia 30308.
Anesth Analg. 1991 Sep;73(3):260-5. doi: 10.1213/00000539-199109000-00005.
Recovery and psychomotor performance were studied in 80 ASA physical status I-III adult patients undergoing outpatient surgery. Patients were divided into four equal groups: thiopental induction of anesthesia followed by desflurane in nitrous oxide and oxygen (Th-DES-N2O/O2), thiopental induction of anesthesia followed by isoflurane in nitrous oxide and oxygen (Th-ISO-N2O/O2), thiopental induction of anesthesia followed by desflurane in oxygen (Th-DES-O2), and desflurane inhaled induction followed by desflurane in oxygen (DES-DES-O2). Patients were excluded from analysis if they required opioids or antiemetics postoperatively. The use of desflurane was associated with more rapid awakening compared with isoflurane (time to eye opening 9.45 +/- 0.67 min [Th-DES-N2O/O2] and 13.8 +/- 1.59 min [Th-ISO-N2O/O2], P less than 0.05). Psychomotor performance was measured using the choice reaction time and critical flicker fusion threshold. At 30 min after discontinuing anesthesia, five patients in the Th-ISO-N2O/O2 group and one patient in the Th-DES-N2O/O2 group were too sleepy to perform psychomotor tests. In addition, five patients who received Th-DES-O2 and one patient who received the inhaled induction and maintenance of anesthesia with desflurane in oxygen were too sleepy to perform tests at 30 min. Patients receiving Th-DES-N2O/O2 showed less impairment of choice reaction time than those receiving Th-ISO-N2O/O2. Critical flicker fusion threshold, however, showed no difference between groups. The use of thiopental was associated with delayed recovery. Compared with isoflurane, desflurane anesthesia is associated with more rapid initial awakening and less impairment of choice reaction time.
对80例接受门诊手术的美国麻醉医师协会（ASA）身体状况为I-III级的成年患者的恢复情况和精神运动表现进行了研究。患者被分为四组，每组人数相等：硫喷妥钠诱导麻醉，随后在氧化亚氮和氧气中使用地氟醚（Th-DES-N2O/O2）；硫喷妥钠诱导麻醉，随后在氧化亚氮和氧气中使用异氟醚（Th-ISO-N2O/O2）；硫喷妥钠诱导麻醉，随后在氧气中使用地氟醚（Th-DES-O2）；地氟醚吸入诱导，随后在氧气中使用地氟醚（DES-DES-O2）。如果患者术后需要使用阿片类药物或止吐药，则将其排除在分析之外。与异氟醚相比，使用地氟醚与更快苏醒相关（睁眼时间：[Th-DES-N2O/O2]组为9.45±0.67分钟，[Th-ISO-N2O/O2]组为13.8±1.59分钟，P<0.05）。使用选择反应时间和临界闪烁融合阈值来测量精神运动表现。在停止麻醉后30分钟，Th-ISO-N2O/O2组有5例患者和Th-DES-N2O/O2组有1例患者过于困倦而无法进行精神运动测试。此外，接受Th-DES-O2的5例患者和接受地氟醚氧气吸入诱导和维持麻醉的1例患者在30分钟时也过于困倦而无法进行测试。接受Th-DES-N2O/O2的患者选择反应时间的受损程度低于接受Th-ISO-N2O/O2的患者。然而，临界闪烁融合阈值在各组之间没有差异。硫喷妥钠的使用与恢复延迟相关。与异氟醚相比，地氟醚麻醉与更快的初始苏醒和选择反应时间的受损程度较轻相关。
