Calderón E, Torres L M
Servicio de Anestesiología-Reanimación y Terapéutica del Dolor, Hospital Universitario Puerta del Mar, Cádiz.
Rev Esp Anestesiol Reanim. 1996 Oct;43(8):272-5.
To assess the clinical signs of awakening and recovery from anesthesia with sevoflurane and 60% nitrous oxide in comparison with halothane and nitrous oxide administered to children.
A prospective study in 39 pediatric ASA I-II patients under 10 years of age scheduled for infraumbilical or otolaryngological surgery. The patients were randomly assigned to 2 groups to receive sevoflurane (n = 20) or halothane (n = 19). All the children received nasal doses of 0.2 mg/kg-1 midazolam before surgery. Induction was achieved by inhalation of a mixture of 40% oxygen and 60% nitrous oxide by face mask along with increasing concentrations of sevoflurane or halothane. Maintenance was with halogenated anesthetic at 1 MAC and 60% nitrous oxide-oxygen along with nerve blockade in the infraumbilical procedures or intravenous analgesia in the otolaryngological operations. We recorded time until awakening, orientation, score on the Aldrete scale and adverse effects during the recovery period.
The children who received sevoflurane awoke and were well oriented earlier than were those in the halothane group (10.7 +/- 5.8 versus 18.7 +/- 9.8 min until awakening and 15.4 +/- 8.6 versus 22.1 +/- 10 min for orientation); likewise the sevoflurane group children received higher scores on Aldrete's scale earlier than did those in the halothane group. There were no statistical differences between the 2 groups with respect to side effects during the period of awakening and recovery.
Awakening and recovery are significantly faster with sevoflurane than with halothane, while the incidence of side effects are similar with the 2 agents.
评估七氟醚和60%氧化亚氮用于小儿麻醉时的苏醒及恢复的临床体征,并与氟烷和氧化亚氮用于小儿麻醉时的情况进行比较。
一项前瞻性研究,纳入39例年龄在10岁以下、拟行脐下或耳鼻喉手术的美国麻醉医师协会(ASA)Ⅰ-Ⅱ级小儿患者。将患者随机分为2组,分别接受七氟醚(n = 20)或氟烷(n = 19)麻醉。所有患儿在手术前经鼻给予0.2 mg/kg的咪达唑仑。通过面罩吸入40%氧气和60%氧化亚氮的混合气体,并逐渐增加七氟醚或氟烷的浓度进行诱导麻醉。维持麻醉采用1个最低肺泡有效浓度(MAC)的卤化麻醉药和60%氧化亚氮-氧气混合气体,脐下手术时联合神经阻滞,耳鼻喉手术时联合静脉镇痛。记录苏醒时间、定向力、Aldrete评分以及恢复期的不良反应。
接受七氟醚麻醉的患儿苏醒时间更早,定向力恢复也更早(苏醒时间:10.7±5.8分钟对18.7±9.8分钟;定向力恢复时间:15.4±8.6分钟对22.1±10分钟);同样,七氟醚组患儿在Aldrete评分上也比氟烷组患儿更早获得更高分数。两组在苏醒和恢复期间的副作用方面无统计学差异。
七氟醚麻醉后的苏醒和恢复明显快于氟烷,而两种药物的副作用发生率相似。