Satomoto Maiko, Adachi Yushi U, Makita Koshi
Department of Anesthesiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Anesthesiology, Graduate School of Medicine, Nagoya University, Aichi, Japan.
Korean J Anesthesiol. 2017 Feb;70(1):27-32. doi: 10.4097/kjae.2017.70.1.27. Epub 2016 Oct 25.
Droperidol (DHB) reportedly reduces the dose of propofol needed to achieve hypnosis when anesthesia is induced and decreases the bispectral index (BIS) in propofol-sedated patients during spinal anesthesia. We reported previously that supplemental DHB decreased the BIS after the administration of sevoflurane and remifentanil. This study investigated the effect of DHB on desflurane (DES) consumption in a clinical setting.
We conducted a prospective, randomized double-blinded study of 35 women with American Society of Anesthesiologist physical status I or II who underwent a mastectomy. Either DHB (20 µg/kg) or a saline placebo was administered to patients 30 min after the induction of anesthesia. A blinded anesthesiologist maintained a BIS value of 50 during anesthesia by modulating inhaled DES concentrations that changed 0.5% at 2.5 min intervals and maintained analgesia via the constant administration of remifentanil by referring to vital signs. The primary endpoint was the effect of DHB on DES consumption. The secondary endpoints included blood circulatory parameters, the time from the end of surgery to extubation, and discharge time between the groups.
The characteristics of the patients did not differ between the groups. The DHB group used a mean of 27.2 ± 6.0 ml of DES compared with 41.4 ± 9.5 ml by the placebo group (P < 0.05).
A small dose of DHB reduced the DES concentration needed to maintain a BIS of 50. Our results show that DHB reduced the consumption of DES without adverse effects.
据报道，氟哌利多（DHB）在诱导麻醉时可降低达到催眠所需的丙泊酚剂量，并在脊麻期间降低丙泊酚镇静患者的脑电双频指数（BIS）。我们之前报道过，在给予七氟醚和瑞芬太尼后补充DHB可降低BIS。本研究在临床环境中调查了DHB对地氟醚（DES）消耗量的影响。
我们对35例美国麻醉医师协会身体状况I或II级、接受乳房切除术的女性进行了一项前瞻性、随机双盲研究。麻醉诱导后30分钟，给患者使用DHB（20μg/kg）或生理盐水安慰剂。一位不知情的麻醉医生通过调节吸入的DES浓度在麻醉期间维持BIS值为50，DES浓度每隔2.5分钟变化0.5%，并通过参考生命体征持续给予瑞芬太尼来维持镇痛。主要终点是DHB对DES消耗量的影响。次要终点包括血液循环参数、手术结束至拔管的时间以及两组之间的出院时间。
两组患者的特征无差异。DHB组平均使用DES 27.2±6.0 ml，而安慰剂组为41.4±9.5 ml（P<0.05）。
小剂量的DHB降低了维持BIS为50所需的DES浓度。我们的结果表明，DHB减少了DES的消耗量且无不良反应。
