Department of Anesthesiology, Sichuan Provincial Orthopedic Hospital, No. 132 West First Section First Ring Road, Chengdu, 610041, Sichuan, China.
BMC Anesthesiol. 2024 Jan 17;24(1):28. doi: 10.1186/s12871-024-02403-1.
During arthroscopic rotator cuff repair (ARCR), clear surgical field visibility (SFV) is the basis of successful surgery, but the choice of anesthesia maintenance drugs may have different effects on SFV. In this study, we aimed to compare the effects of propofol- and sevoflurane-based general anesthesia on SFV in patients undergoing ARCR.
Patients (n = 130) undergoing elective ARCR in the lateral decubitus position were randomized into either the propofol group or sevoflurane group (65 per group). The duration of surgery and increased pressure irrigation (IPI), Boezaart score, rocuronium consumption and usage of remifentanil were recorded. The time of both spontaneous respiration recovery and extubation and the incidences of postoperative nausea and vomiting and agitation were also recorded.
The Boezaart score, duration of IPI and ratio of the duration of IPI to the duration of surgery (IPI/S ratio) were similar between the groups (P > 0.05). Rocuronium consumption, number of patients requiring remifentanil infusion and total remifentanil consumption were significantly lower in the sevoflurane group (P < 0.05). The spontaneous respiration recovery time was significantly longer in the propofol group (P < 0.05), but there were no differences in the extubation time between the groups(P > 0.05).
Compared with propofol, sevoflurane provides equally clear SFV while improving the convenience of anesthesia maintenance in ARCR patients with interscalene plexus (ISB) combined with general anesthesia.
This single-center, prospective, RCT was retrospective registered at Chinese Clinical Trial Registry with the registration number ChiCTR2300072110 (02/06/2023).
在关节镜下肩袖修复术（ARCR）中，清晰的手术视野（SFV）是手术成功的基础，但麻醉维持药物的选择可能对 SFV 产生不同的影响。在这项研究中，我们旨在比较基于丙泊酚和七氟醚的全身麻醉对接受 ARCR 患者 SFV 的影响。
选择侧卧位行择期 ARCR 的患者（n=130），随机分为丙泊酚组或七氟醚组（每组 65 例）。记录手术时间和增加压力冲洗（IPI）、Boezaart 评分、罗库溴铵用量和瑞芬太尼的使用情况。记录自主呼吸恢复时间和拔管时间以及术后恶心和呕吐、躁动的发生率。
两组的 Boezaart 评分、IPI 持续时间和 IPI 持续时间与手术时间的比值（IPI/S 比值）相似（P>0.05）。七氟醚组罗库溴铵用量、需要瑞芬太尼输注的患者数和瑞芬太尼总用量明显减少（P<0.05）。丙泊酚组自主呼吸恢复时间明显延长（P<0.05），但两组拔管时间无差异（P>0.05）。
与丙泊酚相比，七氟醚在联合 ISB 全身麻醉的 ARCR 患者中提供了同样清晰的 SFV，同时提高了麻醉维持的便利性。
这是一项单中心、前瞻性、RCT，在中国临床试验注册中心进行了回顾性注册，注册号 ChiCTR2300072110（2023 年 02 月 06 日）。
