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丙泊酚、地氟醚和七氟醚对经鼻内镜蝶窦垂体手术患者呼吸功能的影响:一项前瞻性随机研究。

Effects of propofol, desflurane, and sevoflurane on respiratory functions following endoscopic endonasal transsphenoidal pituitary surgery: a prospective randomized study.

机构信息

Department of Anesthesiology and Intensive Care, Cerrahpasa School of Medicine, University of Istanbul-Cerrahpasa, Istanbul, Turkey.

Department of Biostatistics, Cerrahpasa School of Medicine, University of Istanbul-Cerrahpasa, Istanbul, Turkey.

出版信息

Korean J Anesthesiol. 2019 Dec;72(6):583-591. doi: 10.4097/kja.19336. Epub 2019 Oct 11.

DOI:10.4097/kja.19336
PMID:31602965
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6900426/
Abstract

BACKGROUND

General anesthesia with intravenous or inhalation anesthetics reduces respiratory functions. We investigated the effects of propofol, desflurane, and sevoflurane on postoperative respiratory function tests.

METHODS

This single-center randomized controlled study was performed in a university hospital from October 2015 to February 2017. Ninety patients scheduled for endoscopic endonasal transsphenoidal pituitary surgery were randomly categorized into either of these three groups: propofol (n = 30, the Group TIVA), desflurane (n = 30, the Group D) or sevoflurane (n = 30, the Group S). We analyzed the patients before, after, and 24 h following surgery, to identify the following parameters: forced expiratory volume in 1 second (FEV1) %, forced vital capacity (FVC) %, FEV1/FVC, and arterial blood gases (ABG). Furthermore, we also recorded the intraoperative dynamic lung compliance and airway resistance values.

RESULTS

We did not find any significant differences in FEV1 values (primary outcome) among the groups (P = 0.336). There was a remarkable reduction in the FEV1 and FVC values in all groups postoperatively relative to the baseline (P < 0.001). The FVC, FEV1/FVC, ABG analysis, compliance, and airway resistance were similar among the groups. Intraoperative dynamic compliance values were lower at the 1st and 2nd hours than those immediately after intubation (P < 0.001).

CONCLUSIONS

We demonstrated that propofol, desflurane, and sevoflurane reduced FEV1 and FVC values postoperatively, without any significant differences among the drugs.

摘要

背景

静脉或吸入麻醉会降低呼吸功能。我们研究了异丙酚、地氟醚和七氟醚对术后呼吸功能测试的影响。

方法

这是一项在大学医院进行的单中心随机对照研究,时间为 2015 年 10 月至 2017 年 2 月。90 例拟行内镜经鼻蝶窦垂体手术的患者被随机分为三组:异丙酚组(n = 30,TIVA 组)、地氟醚组(n = 30,D 组)或七氟醚组(n = 30,S 组)。我们分析了患者术前、术后和术后 24 小时的以下参数:第 1 秒用力呼气量(FEV1)%、用力肺活量(FVC)%、FEV1/FVC 和动脉血气(ABG)。此外,我们还记录了术中动态肺顺应性和气道阻力值。

结果

三组患者的 FEV1 值(主要结局)无显著差异(P = 0.336)。所有组术后的 FEV1 和 FVC 值均较基线显著降低(P < 0.001)。FVC、FEV1/FVC、ABG 分析、顺应性和气道阻力在各组间相似。术中动态顺应性值在第 1 小时和第 2 小时低于插管后即刻(P < 0.001)。

结论

我们表明,异丙酚、地氟醚和七氟醚术后均降低 FEV1 和 FVC 值,但药物之间无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1eb/6900426/21f122c31fb1/kja-19336f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1eb/6900426/21f122c31fb1/kja-19336f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1eb/6900426/21f122c31fb1/kja-19336f1.jpg

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WHO Needs High FIO?谁需要高吸入氧分数?
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Efficacy of continuous positive airway pressure and incentive spirometry on respiratory functions during the postoperative period following supratentorial craniotomy: A prospective randomized controlled study.经颅幕上手术后持续气道正压通气和激励式呼吸训练对呼吸功能的影响:一项前瞻性随机对照研究。
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Effects of propofol or desflurane on post-operative spirometry in elderly after knee surgery: a double-blind randomised study.丙泊酚或地氟醚对老年膝关节手术后肺活量测定的影响:一项双盲随机研究。
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