Valanne J V, Korttila K
Anesth Prog. 1988 Mar-Apr;35(2):48-52.
Anesthesia was induced in 120 unpremedicated, healthy patients undergoing outpatient dentistry or oral surgery with methohexital, and endotracheal intubation facilitated with succinylcholine. Anesthesia was maintained randomly with either enflurane or isoflurane in nitrous oxide and oxygen (50%) administered in a nonrebreathing circuit using spontaneous respiration. After both enflurane and isoflurane anesthesia, it took 12-13 minutes before the patients were oriented as to time and place. The patients' ability to walk along a straight line normalized significantly (p < .05) more quickly after isoflurane than after enflurane anesthesia. Long enflurane anesthesia (>90 minutes) was associated with a significantly (p < .05-p < .01) slower recovery of walking ability and of psychomotor performance in a perceptual speed test than was short enflurane anesthesia (<40 minutes). With isoflurane the speed of recovery did not depend on the duration of anesthesia. After both anesthetic techniques, 25-26% of the patients had nausea or vomited. We conclude that using spontaneous respiration recovery is faster after isoflurane anesthesia than after enflurane anesthesia and that isoflurane should be preferred to enflurane for long anesthesia of outpatients.
对120例未接受术前用药的健康患者进行门诊牙科或口腔外科手术,使用美索比妥诱导麻醉,并使用琥珀酰胆碱辅助气管插管。麻醉维持阶段,随机采用恩氟烷或异氟烷,在笑气和氧气(50%)中,通过非再呼吸回路以自主呼吸方式给药。恩氟烷和异氟烷麻醉后,患者恢复对时间和地点的定向需12 - 13分钟。异氟烷麻醉后患者沿直线行走的能力恢复正常的速度比恩氟烷麻醉后显著更快(p < 0.05)。与短时间恩氟烷麻醉(<40分钟)相比,长时间恩氟烷麻醉(>90分钟)后,患者在感知速度测试中的行走能力和精神运动表现恢复明显更慢(p < 0.05 - p < 0.01)。而异氟烷麻醉后的恢复速度不取决于麻醉持续时间。两种麻醉技术后,均有25 - 26%的患者出现恶心或呕吐。我们得出结论,异氟烷麻醉后采用自主呼吸恢复比恩氟烷麻醉后更快,对于门诊患者的长时间麻醉,异氟烷应优先于恩氟烷使用。