Shan Jinghua, Sun Lianmei, Wang Dewei, Li Xiuhua
Department of Anesthesia, Affiliated Hospital of Weifang Medical University Weifang 261053, Shandong province, China.
Department of Anesthesia, Weifang Medical University Weifang 261053, Shandong province, China.
Int J Clin Exp Pathol. 2015 Feb 1;8(2):2001-9. eCollection 2015.
There are a few reports regarding the comparison of these anesthetic agents, but previous studies mainly focus on the veterinary anesthesiology. Less attention has been focused comparing the effectiveness of these inhalational anesthetic agents in neurosurgery. This lack of interest is regretful particularly considering the fact that anesthetics during neurosurgery are an issue of extreme sensitivity and subtlety, where the cerebral oxygenation process plays a significant role in the neuroprotective mechanisms.
The purpose of this retrospective study is to contribute to the existing knowledge of the comparative studies of the volatile anesthetic agents such as isoflurane, sevoflurane and desflurane by evaluating the maintenance and emergence characteristics after volatile anesthetics-induced preconditioning with isoflurane, sevoflurane or desflurane for inpatient ischemia/reperfusion cerebral injury during cerebral or neural surgeries.
The aim was to investigate their neuroprotective mechanisms and effects by analyzing and comparing the superiority of each agent in a Chinese patient population, in terms of faster emergence, and early and intermediate recovery. The intraoperative haemodynamic profiles and postoperative adverse effects of these three agents were also systematically analyzed.
We found that sevoflurane, when compared with isoflurane and desflurane, provided anesthesia with similar hemodynamic stability but allowed for a smoother, more rapid emergence and better quality of induction and recovery to surgical patients under clinical conditions, particularly to those who were experiencing substantial cerebral vasodilation.
Sevoflurane offers several advantages, including a relative lack of airway irritation, a more rapid onset and recovery, and greater hemodynamic stability than other potent inhaled agents. These properties would appear to afford sevoflurane significant clinical potential.
关于这些麻醉剂的比较已有一些报道，但先前的研究主要集中在兽医麻醉学领域。较少有研究关注比较这些吸入性麻醉剂在神经外科手术中的有效性。鉴于神经外科手术中的麻醉是一个极其敏感和微妙的问题，其中脑氧合过程在神经保护机制中起着重要作用，这种缺乏关注的情况令人遗憾。
本回顾性研究的目的是通过评估异氟烷、七氟烷或地氟烷诱导预处理后，在脑部或神经手术期间对住院患者缺血/再灌注脑损伤的挥发性麻醉剂的维持和苏醒特征，为挥发性麻醉剂如异氟烷、七氟烷和地氟烷的比较研究的现有知识做出贡献。
目的是通过分析和比较每种药物在中国患者群体中的优势，即更快的苏醒以及早期和中期恢复情况，来研究它们的神经保护机制和效果。还系统分析了这三种药物的术中血流动力学特征和术后不良反应。
我们发现，与异氟烷和地氟烷相比，七氟烷在临床条件下为手术患者提供了相似的血流动力学稳定性，但苏醒更平稳、更快，诱导和恢复质量更好，尤其是对那些出现明显脑血管扩张的患者。
七氟烷具有多种优势，包括相对缺乏气道刺激、起效和恢复更快，以及比其他强效吸入剂具有更大的血流动力学稳定性。这些特性似乎赋予七氟烷显著的临床潜力。
