Li Qian, Yang Di, Liu Jin, Zhang Han, Zhang Jingyu
Department of Anesthesiology and Translational Neuroscience Center, West China Hospital of Sichuan University, Chengdu, China.
Basic Clin Pharmacol Toxicol. 2014 Aug;115(2):222-8. doi: 10.1111/bcpt.12223. Epub 2014 Mar 24.
Recovery time and quality after general anaesthesia is important for patient safety. This study aimed to determine whether intravenous lipid emulsion could improve recovery profiles from isoflurane anaesthesia in adult patients undergoing laparoscopic cholecystectomy. Sixty-six patients were enrolled. After anaesthesia induction, inspired isoflurane concentration was adjusted to maintain stable vital signs and the suitable conditions for operation. At the end of the operation, the isoflurane was discontinued, and either 2 ml/kg 30% lipid emulsions or 0.9% saline solution was administered intravenously. The time to eye opening, extubation and exit from the operation room was recorded, and the quality of recovery from anaesthesia was assessed. Sixty patients completed the study. The median time to eye opening and exit from the operation room was significantly shorter in the lipid emulsion group than in the saline group [15.5 (interquartile range 9.0) versus 20.0 (10.0) min., p = 0.01; 19.5 (8.3) versus 23.6 (6.3) min., p = 0.04, respectively], whereas the median time to extubation did not show any noticeable difference. The quality of recovery was better in the lipid emulsion group than that of the saline solution group with respect to drowsiness visual analogue scale score (p < 0.01), Observer's Assessment of Alertness/Sedation score (p < 0.01), Mini-Mental State Examination score (p = 0.04) and Modified Aldrete Post Anaesthesia Recovery score (p = 0.03). No serious adverse events were observed during the study period. In conclusion, intravenous lipid emulsion may effectively improve the recovery time and quality from isoflurane anaesthesia for laparoscopic cholecystectomy.
全身麻醉后的恢复时间和质量对患者安全至关重要。本研究旨在确定静脉输注脂质乳剂是否能改善接受腹腔镜胆囊切除术的成年患者异氟烷麻醉后的恢复情况。纳入了66例患者。麻醉诱导后，调整异氟烷吸入浓度以维持稳定的生命体征和合适的手术条件。手术结束时，停止使用异氟烷，并静脉注射2 ml/kg 30%的脂质乳剂或0.9%的生理盐水。记录睁眼、拔管和离开手术室的时间，并评估麻醉恢复质量。60例患者完成了研究。脂质乳剂组的睁眼和离开手术室的中位时间显著短于生理盐水组[分别为15.5（四分位间距9.0）对20.0（10.0）分钟，p = 0.01；19.5（8.3）对23.6（6.3）分钟，p = 0.04]，而拔管的中位时间没有明显差异。在嗜睡视觉模拟量表评分（p < 0.01）、观察者警觉/镇静评估评分（p < 0.01）、简易精神状态检查表评分（p = 0.04）和改良Aldrete麻醉后恢复评分（p = 0.03）方面，脂质乳剂组的恢复质量优于生理盐水组。研究期间未观察到严重不良事件。总之，静脉输注脂质乳剂可能有效改善腹腔镜胆囊切除术异氟烷麻醉后的恢复时间和质量。
