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咖啡因对接受腹股沟疝修补术儿童吸入麻醉后全麻苏醒加速的影响:一项随机临床试验

Effect of Caffeine on the Acceleration of Emergence from General Anesthesia with Inhalation Anesthetics in Children Undergoing Inguinal Herniorrhaphy: A Randomized Clinical Trial.

作者信息

Emami Soodabeh, Panah Ashkan, Hakimi Seyed Shaheen, Sahmeddini Mohammad Ali

机构信息

Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Iran J Med Sci. 2022 Mar;47(2):107-113. doi: 10.30476/IJMS.2021.87688.1818.

Abstract

BACKGROUND

Awakening following general anesthesia (GA) is one of the most important concerns of anesthesiologists in their daily work. Previous studies on adult humans found that caffeine could accelerate awakening after anesthesia. This study aimed to determine whether or not caffeine can accelerate awakening after anesthesia in children undergoing inguinal herniorrhaphy under GA.

METHODS

In this randomized clinical trial, we enrolled 18 children undergoing inguinal herniorrhaphy under GA with inhaled anesthetics from June 2019 to September 2019 in the tertiary hospital affiliated with Shiraz University of Medical Sciences (Shiraz, Iran). These children were randomly allocated to two groups. In group A, the children received intravenous caffeine (10 mg/Kg) at the end of the surgery, and in group B, the children received intravenous normal saline at the end of the surgery. The primary outcome was laryngeal mask airway (LMA) removal time at the end of anesthesia. Intra-operative hemodynamic data and side effects such as nausea, vomiting, dysrhythmia, cyanosis, and seizures in the recovery room were recorded and compared between the two groups. We used the independent-samples test, Fisher's exact test, and repeated measures ANOVA for analyzing the data. P values<0.05 were considered statistically significant.

RESULTS

There were no significant differences in terms of demographic characteristics and hemodynamic data between the two groups. Furthermore, the time from the induction of anesthesia to laryngeal mask removal was 44.77±7.87 min in the placebo group and 44.55±10.68 min in the caffeine group. Therefore, there was no significant difference between the two groups (P=0.961).

CONCLUSION

In children undergoing inguinal herniorrhaphy under GA, 10 mg/Kg of caffeine could not accelerate awakening from GA. However, caffeine did not increase the blood pressure and heart rate in the children, and no significant side effects were observed.

TRIAL REGISTRATION NUMBER

IRCT20190511043550N1.

摘要

背景

全身麻醉(GA)后的苏醒是麻醉医生日常工作中最为关注的问题之一。先前针对成年人类的研究发现,咖啡因可加速麻醉后的苏醒。本研究旨在确定咖啡因能否加速接受GA下腹股沟疝修补术的儿童麻醉后的苏醒。

方法

在这项随机临床试验中,我们于2019年6月至2019年9月在设拉子医科大学附属三级医院(伊朗设拉子)纳入了18例接受吸入麻醉剂GA下腹股沟疝修补术的儿童。这些儿童被随机分为两组。A组儿童在手术结束时接受静脉注射咖啡因(10mg/kg),B组儿童在手术结束时接受静脉注射生理盐水。主要结局是麻醉结束时喉罩气道(LMA)拔除时间。记录并比较两组在恢复室中的术中血流动力学数据以及恶心、呕吐、心律失常、发绀和惊厥等副作用。我们使用独立样本检验、Fisher精确检验和重复测量方差分析来分析数据。P值<0.05被认为具有统计学意义。

结果

两组在人口统计学特征和血流动力学数据方面无显著差异。此外,安慰剂组从麻醉诱导到喉罩拔除的时间为44.77±7.87分钟,咖啡因组为44.55±10.68分钟。因此,两组之间无显著差异(P = 0.961)。

结论

在接受GA下腹股沟疝修补术的儿童中,10mg/kg的咖啡因不能加速GA后的苏醒。然而,咖啡因并未增加儿童的血压和心率,且未观察到显著的副作用。

试验注册号

IRCT20190511043550N1。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc7/8919303/fade60e287e8/IJMS-47-107-g001.jpg

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