Department of Anaesthesia and Perioperative Medicine, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia.
Br J Anaesth. 2011 Jun;106(6):832-9. doi: 10.1093/bja/aer094. Epub 2011 May 9.
Numerous studies have shown that women emerge faster from general anaesthesia than men, and differ in their postoperative recovery profile. The extent and underlying mechanisms for these sex-related differences in general anaesthesia are unclear.
In a multicentre, prospective, matched cohort study, 500 ASA physical status I or II patients of either sex undergoing general anaesthesia for elective surgery were recruited. All subjects received a general anaesthetic through inhalation. Anaesthetic drugs and doses used, bispectral index (BIS) scores, recovery times, pain scores, and 40-item quality of recovery (QoR-40) scores for 3 days after general anaesthesia were recorded.
Women had higher BIS scores at similar concentrations of anaesthesia (P<0.05). Time to eye-opening (P<0.01) and time to obeying commands (P<0.01) were shorter in women. Duration of recovery room stay was longer in women, who also had higher pain scores and need for treatment of nausea and vomiting (all P<0.001). QoR-40 scores for the first 3 days after general anaesthesia were lower in women (P<0.001). Plasma progesterone concentrations in women negatively correlated with the time to eye-opening (ρ=-0.53, P=0.01).
Patient sex is an independent factor influencing the response to anaesthesia and recovery after surgery. Women emerged faster from general anaesthesia but their overall quality of recovery was poorer. Female sex hormones, particularly progesterone, might be involved, with premenopausal women having faster recovery time but poor overall recovery.
大量研究表明，女性在全身麻醉中苏醒的速度快于男性，并且在术后恢复过程中存在差异。全身麻醉中这些性别相关差异的程度和潜在机制尚不清楚。
在一项多中心、前瞻性、匹配队列研究中，招募了 500 名 ASA 身体状况 I 或 II 级、接受择期手术全身麻醉的男女患者。所有患者均通过吸入接受全身麻醉。记录所有患者的麻醉药物和剂量、脑电双频指数（BIS）评分、恢复时间、疼痛评分以及全身麻醉后 3 天的 40 项恢复质量（QoR-40）评分。
女性在相似的麻醉浓度下 BIS 评分更高（P<0.05）。女性的睁眼时间（P<0.01）和听从指令时间（P<0.01）更短。女性在恢复室的停留时间更长，疼痛评分更高，需要治疗恶心和呕吐的情况也更多（均 P<0.001）。女性全身麻醉后前 3 天的 QoR-40 评分较低（P<0.001）。女性的血浆孕激素浓度与睁眼时间呈负相关（ρ=-0.53，P=0.01）。
患者性别是影响麻醉反应和术后恢复的独立因素。女性在全身麻醉中苏醒更快，但整体恢复质量较差。女性性激素，尤其是孕激素，可能参与其中，绝经前女性的恢复时间较快，但整体恢复较差。
