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接受鼻部手术患者的恢复情况:七氟醚与丙泊酚的比较

Recovery profile of patients undergoing nasal surgical procedures: a comparison between sevoflurane and propofol.

作者信息

Haq Aziz Ul, Aqil Mansoor, Rasheed Amjad, Ahmed Rana Altaf

机构信息

King Abdul - Aziz University Hospital, P.O. Box 245, Riyadh, 11411 Saudi Arabia.

出版信息

Indian J Otolaryngol Head Neck Surg. 2008 Jun;60(2):123-7. doi: 10.1007/s12070-008-0054-5. Epub 2008 Jul 23.

Abstract

OBJECTIVES

To compare the recovery profile of sevoflurane and propofol in nasal surgical procedures.

DESIGN

A prospective, double blind, randomized study

SETTING

King Abdul Aziz University Hospital, Riyadh, Saudi Arabia, a tertiary care teaching hospital, attached with King Saud University, Riyadh Saudi Arabia.

PATIENTS

60 ASA I-II patients age between 18-35 years, and weighing 50-80 kg, scheduled for nasal surgical procedures.

METHODS

Patients were assigned randomly to one of the two groups, the Sevoflurane Group-S (n = 30) & the Propofol Group-P (n = 30). Anesthetic induction was carried out using propofol 2.0mg/kg.in both the groups. Cis-atracurium 0.15mg/kg was given for intubation. Airway was protected with a throat pack around the endo-tracheal tube. Fentanyl 1microgram/kg was given as bolus followed by infusion at a rate of 1 microgram/kg/ hour. Anesthesia was maintained with sevoflurane 2% in Group-S, and propofol infusion at a rate of 200 microgram/kg/min. in Group-P. 50% oxygen in nitrous oxide was given in both the groups. At the end of surgery, patients were extubated after reversal of the neuromuscular block. Immediate recovery was assessed by recording the time to breathe spontaneously, time to extubation, and time of spontaneous eyes movements from the time of giving reversal. Ketoprofen 1.5mg/kg intramuscularly was given to all patients before transfer to (PACU). In PACU, sedation score was assessed for 45 min. Intermediate recovery was assessed by TDT and DSST at 15, 30 and 45 min. Time taken to state name and father's name was recorded.

RESULTS

Patients in Group-S breathed significantly earlier than those in Group-P. Group-P showed significantly better performance with TDT at 45 min and with DSST at 30 and 45 min.

CONCLUSIONS

We conclude that both sevoflurane and propofol provide early and comparable post anesthesia recovery for patients undergoing nasal surgical procedures.

摘要

目的

比较七氟醚和丙泊酚在鼻科手术中的恢复情况。

设计

一项前瞻性、双盲、随机研究

地点

沙特阿拉伯利雅得阿卜杜勒阿齐兹国王大学医院,这是一家三级医疗教学医院,隶属于沙特阿拉伯利雅得沙特国王大学。

患者

60例年龄在18 - 35岁、体重50 - 80千克的美国麻醉医师协会(ASA)分级为I - II级的患者,计划进行鼻科手术。

方法

患者被随机分配到两组之一,七氟醚组 - S(n = 30)和丙泊酚组 - P(n = 30)。两组均使用2.0mg/kg丙泊酚进行麻醉诱导。给予顺式阿曲库铵0.15mg/kg用于插管。气管内导管周围用喉罩保护气道。给予芬太尼1微克/千克静脉推注,随后以1微克/千克/小时的速率输注。S组用2%七氟醚维持麻醉,P组以200微克/千克/分钟的速率输注丙泊酚。两组均给予50%氧气和氧化亚氮。手术结束时,在神经肌肉阻滞逆转后对患者进行拔管。通过记录自主呼吸时间、拔管时间以及从给予逆转剂到自主眼球运动的时间来评估即刻恢复情况。所有患者在转入麻醉后恢复室(PACU)前肌内注射酮洛芬1.5mg/kg。在PACU中,评估45分钟的镇静评分。在15、30和45分钟时通过改良警觉/镇静评分(MAAS)和数字符号替换试验(DSST)评估中期恢复情况。记录说出自己名字和父亲名字所用的时间。

结果

S组患者比P组患者更早开始自主呼吸。P组在45分钟时的MAAS以及30和45分钟时的DSST表现明显更好。

结论

我们得出结论,七氟醚和丙泊酚为接受鼻科手术的患者提供了早期且相当的麻醉后恢复效果。

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