七氟烷和地氟烷在全髋关节置换手术患者中的早期恢复特性。
Early recovery properties of sevoflurane and desflurane in patients undergoing total hip replacement surgery.
作者信息
Dogru Kudret, Yildiz Karamehmet, Madenoglu Halit, Boyaci Adem
机构信息
Department of Anaesthesiology, Erciyes University School of Medicine, Kayseri, Turkey.
出版信息
Curr Ther Res Clin Exp. 2003 May;64(5):301-9. doi: 10.1016/S0011-393X(03)00086-9.
BACKGROUND
The pharmacokinetic properties of sevoflurane and desflurane differ from those of other volatile anesthetics. For example, both agents allow more rapid emergence than traditional volatile anesthetics. However, few direct comparisons of the 2 agents have been made.
OBJECTIVE
The aim of this study was to compare the early recovery properties of desflurane and sevoflurane in patients with American Society of Anesthesiologists physical status I or II undergoing total hip replacement (THR) surgery.
METHODS
This open-label study was performed at the Department of Anesthesiology, Erciyes University School of Medicine, Kayseri, Turkey. Early recovery was assessed in the surgical suite by measuring the time to 50% decline of end-tidal volatile concentration of desflurane or sevoflurane; time to extubation, eye opening, orientation, and a modified Aldrete Scale (MAS) score >8 (ie, safe to discharge from the surgical suite); and time to discharge from the postanesthesia recovery room.
RESULTS
Time to 50% decline of end-tidal volatile concentration of desflurane or sevoflurane, tracheal extubation, eye opening, orientation, and an MAS score >8 occurred significantly more rapidly in the desflurane group than in the sevoflurane group (P<0.001). However, the groups did not differ significantly in duration of anesthesia; time to discharge from the postanesthesia recovery room; or incidences of nausea, vomiting, dizziness, and drowsiness in the first 24 hours after anesthesia.
CONCLUSIONS
In this study population, desflurane provided significantly more rapid early recovery than sevoflurane, but we did not find any beneficial effects of desflurane on intermediate recovery. The rapid emergence from anesthesia may facilitate more efficient surgical suite use and may be associated with more benefits after prolonged anesthesia. We suggest that both volatile agents may be acceptable anesthetics for use during THR surgery.
背景
七氟烷和地氟烷的药代动力学特性与其他挥发性麻醉剂不同。例如，与传统挥发性麻醉剂相比，这两种药物都能使患者更快苏醒。然而，很少有人对这两种药物进行直接比较。
目的
本研究旨在比较地氟烷和七氟烷在接受全髋关节置换（THR）手术的美国麻醉医师协会身体状况I或II级患者中的早期恢复特性。
方法
本开放标签研究在土耳其开塞利埃尔西耶斯大学医学院麻醉科进行。在手术室内通过测量地氟烷或七氟烷呼气末挥发性浓度下降50%的时间、拔管时间、睁眼时间、定向时间以及改良的Aldrete评分>8（即从手术室安全出院）的时间来评估早期恢复情况；并记录从麻醉后恢复室出院的时间。
结果
地氟烷组呼气末挥发性浓度下降50%的时间、气管拔管时间、睁眼时间、定向时间以及改良的Aldrete评分>8的时间均显著快于七氟烷组（P<0.001）。然而，两组在麻醉持续时间、从麻醉后恢复室出院的时间以及麻醉后24小时内恶心、呕吐、头晕和嗜睡的发生率方面无显著差异。
结论
在本研究人群中，地氟烷的早期恢复明显快于七氟烷，但我们未发现地氟烷对中期恢复有任何有益影响。麻醉后快速苏醒可能有助于更有效地使用手术室，并且可能与长时间麻醉后的更多益处相关。我们建议这两种挥发性麻醉剂均可用于THR手术。
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