Cook T L, Smith M, Winter P M, Starkweather J A, Eger E I
Anesth Analg. 1978 Jul-Aug;57(4):434-40. doi: 10.1213/00000539-197807000-00012.
Ten male volunteers performed 3 tasks before, during, and following administration of 3 levels of alveolar halothane (0.05, 0.1, and 0.2%) for one-half hour each and (on a separate occasion) enflurane (0.15, 0.3, and 0.4%) for one-half hour each. The concentrations of halothane tested representing 7, 13, and 27% of MAC values, respectively; those of enflurane were 9, 18, and 24% of MAC. The tasks were a choice-reaction time test, a digit span test, and a Purdue Pegboard Assembly test. Volunteers also were tested for amnesia with word pairs and a picture. No effects or only slight effects on mental function could be detected at the lowest concentrations of either agent. At higher concentrations both agents impaired function, as indicated by an increase in reaction time, decreased ability to remember numbers, and decreased ability to assemble a simple structural array. Amnesia for word pairs but not pictures occurred at 27% of MAC for halothane and 18% of MAC for enflurane. All test scores reverted to control levels within one-half hour after discontinuing the anesthetic. Our results indicate that subanesthetic but not trace levels of enflurane or halothane can impair mental performance and manual dexterity and produce amnesia. The levels of anesthetic required far exceed those experienced by operating room personnel. However, such levels might be found for several hours in patients following prolonged anesthesia.
十名男性志愿者在吸入三种浓度的氟烷(0.05%、0.1%和0.2%),每种浓度各持续半小时,以及(在另一个时间段)吸入恩氟烷(0.15%、0.3%和0.4%),每种浓度各持续半小时之前、期间和之后,分别进行了三项任务。所测试的氟烷浓度分别相当于最低肺泡有效浓度(MAC)值的7%、13%和27%;恩氟烷的浓度分别为MAC的9%、18%和24%。这些任务包括选择反应时间测试、数字广度测试和普渡木钉板装配测试。志愿者还接受了单词对和图片的失忆测试。在两种药物的最低浓度下,未检测到对心理功能有影响或仅有轻微影响。在较高浓度下,两种药物均损害了功能,表现为反应时间增加、记忆数字能力下降以及组装简单结构阵列的能力下降。对于氟烷,在MAC的27%时出现了对单词对的失忆,但对图片没有失忆;对于恩氟烷,在MAC的18%时出现了对单词对的失忆。停止麻醉后半小时内,所有测试分数均恢复到对照水平。我们的结果表明,低于麻醉剂量但并非微量的恩氟烷或氟烷会损害心理表现和手部灵活性,并导致失忆。所需的麻醉剂水平远远超过手术室人员所经历的水平。然而,在长时间麻醉后的患者中,可能会在数小时内出现这样的水平。