Anesthesiology Department, College of Medicine, University of Dammam, P.O. 40289, Dammam, Al Khobar, 31952, Saudi Arabia.
J Anesth. 2011 Oct;25(5):648-56. doi: 10.1007/s00540-011-1190-8. Epub 2011 Jul 14.
Aminophylline accelerates the recovery from sevoflurane anesthesia. We studied the effects of escalating doses of aminophylline on cognitive and clinical recovery after sevoflurane anesthesia.
After ethical approval and informed consent, 150 patients scheduled for elective surgery under sevoflurane-fentanyl anesthesia were randomly allocated to receive saline or 2, 3, 4 or 5 mg/kg of aminophylline (n = 30 for each) at the end of anesthesia (T (0)). Short Orientation Memory Concentration Test (SOMCT) scores, entropy values, end-tidal sevoflurane concentrations (EtSevo), times to eyes opening and extubation, respiratory rate (RR) and tidal volume (TV) were recorded.
Compared to placebo, patients receiving 2, 3, 4 and 5 mg/kg of aminophylline had higher SOMCT scores [median (25th percentile/75th percentile) 20.6 (19/23), 21.5 (21/22), 24.5 (24-25), 25.5 (25/26), respectively, vs. 13.5 (13/14) at 30 min after extubation, and 24 (22/26), 25 (24/26), 27.5 (27-28), 27.5 (27/28), respectively, vs. 18.5 (18/19) at 45 min after extubation], higher entropy values for the first 10 min after T (0), lower EtSevo for the first 4 min after T (0), shorter times to eyes opening [5 (4.0/6.0), 5 (4.0/6.0), 4 (2.0/5.5), and 4 (2.0/6.0), respectively, vs. 9.8 (8.0/11.0) min], shorter times to extubation, shorter times to home discharge (P < 0.001), and higher RR and larger TV values. Patients who received 4 and 5 mg/kg of aminophylline showed higher SOMCT scores, 6 min shorter times to eyes opening and to extubation, and 58 min shorter times to home discharge.
The administration of escalating doses of aminophylline accelerates postoperative cognitive recovery from sevoflurane anesthesia, as measured by the SOMCT, due to increased ventilatory elimination of sevoflurane.
氨茶碱可加速七氟醚麻醉后的恢复。我们研究了递增剂量的氨茶碱对七氟醚麻醉后认知和临床恢复的影响。
在伦理批准和知情同意后，150 名计划在七氟醚-芬太尼麻醉下接受择期手术的患者被随机分配接受生理盐水或 2、3、4 或 5mg/kg 的氨茶碱（每组 30 名）在麻醉结束时（T（0））。记录短定向记忆浓度测试（SOMCT）评分、熵值、呼气末七氟醚浓度（EtSevo）、睁眼和拔管时间、呼吸频率（RR）和潮气量（TV）。
与安慰剂相比，接受 2、3、4 和 5mg/kg 氨茶碱的患者 SOMCT 评分更高[中位数（25 百分位/75 百分位）分别为 20.6（19/23）、21.5（21/22）、24.5（24-25）、25.5（25/26），分别在拔管后 30 分钟，和 24（22/26）、25（24/26）、27.5（27-28）、27.5（27/28），分别在拔管后 45 分钟]，T（0）后 10 分钟内的熵值更高，T（0）后 4 分钟内的 EtSevo 更低，睁眼时间更短[5（4.0/6.0）、5（4.0/6.0）、4（2.0/5.5）和 4（2.0/6.0），分别为 9.8（8.0/11.0）min]，拔管时间更短，出院时间更早（P<0.001），RR 和 TV 值更高。接受 4 和 5mg/kg 氨茶碱的患者 SOMCT 评分更高，睁眼和拔管时间分别缩短 6 分钟，出院时间缩短 58 分钟。
递增剂量的氨茶碱通过增加七氟醚的通气消除，加速七氟醚麻醉后术后认知恢复，这可以通过 SOMCT 来测量。
