van den Berg A A, Honjol N M, Mphanza T, Rozario C J, Joseph D
Department of Anaesthesia, Riyadh Armed Forces Hospital, Kingdom of Saudi Arabia.
Acta Anaesthesiol Scand. 1998 Jul;42(6):658-63. doi: 10.1111/j.1399-6576.1998.tb05298.x.
Isoflurane has exceeded halothane and enflurane in usage. A literature search, however, revealed no data comparing the effects on emesis, headache and restlessness of these three agents.
With hospital ethics committee approval and patient consent, a prospective, randomised, double-blind study of 556 patients undergoing ENT and eye surgery was undertaken to evaluate the effects of halothane, isoflurane and enflurane on vomiting, retching, headache and restlessness until 24 h after anaesthesia. Balanced general anaesthesia was administered comprising benzodiazepine premedication, induction with thiopentone-atracurium-morphine (ENT patients) or fentanyl (eye patients), controlled ventilation and maintenance with either halothane 0.4-0.6 vol% (n = 186), isoflurane 0.6-0.8 vol% (n = 184) or enflurane 0.8-1 vol% (n = 186) in nitrous oxide 67% and oxygen.
The three study groups were comparable, and comprised comparable subgroups having ear, nose, throat, intraocular and non-intraocular surgery. During early recovery from anaesthesia, the respective requirements for halothane, isoflurane and enflurane for analgesia (7%, 9% and 10%), frequency of emesis (6%, 8% and 8%), antiemetic requirements (1%, 1% and 2%), restlessness-pain scores and time spent in the recovery ward (27 SD 10, 31 SD 12 and 26 SD 9 min) were similar. During the ensuing 24-h postoperative period, patients who had isoflurane experienced emesis less often than those who had halothane (36% vs 46%, P < 0.025) but did so with similar frequency to those who had enflurane (46% vs 41%). Antiemetic requirements were least in those given isoflurane (isoflurane 12%, halothane and enflurane 23% each, P < 0.005), but headache and analgesic requirements were similar.
Isoflurane induces less postoperative emesis than halothane, but headache is similarly frequent after anaesthesia with any of these agents.
异氟烷的使用已超过氟烷和恩氟烷。然而，文献检索未发现比较这三种药物对呕吐、头痛和烦躁影响的数据。
在获得医院伦理委员会批准并征得患者同意后，对556例接受耳鼻喉科和眼科手术的患者进行了一项前瞻性、随机、双盲研究，以评估氟烷、异氟烷和恩氟烷对麻醉后24小时内呕吐、干呕、头痛和烦躁的影响。采用平衡全身麻醉，包括苯二氮卓类药物术前用药，硫喷妥钠 - 阿曲库铵 - 吗啡（耳鼻喉科患者）或芬太尼（眼科患者）诱导，控制通气，并在67%氧化亚氮和氧气中分别用0.4 - 0.6体积%氟烷（n = 186）、0.6 - 0.8体积%异氟烷（n = 184）或0.8 - 1体积%恩氟烷（n = 186）维持麻醉。
三个研究组具有可比性，并且包括进行耳、鼻、喉、眼内和非眼内手术的可比亚组。在麻醉早期恢复期间，氟烷、异氟烷和恩氟烷在镇痛方面的各自需求量（7%、9%和10%）、呕吐频率（6%、8%和8%）、止吐药需求量（1%、1%和2%）、烦躁 - 疼痛评分以及在恢复病房的停留时间（27±10、31±12和26±9分钟）相似。在随后的术后24小时内，使用异氟烷的患者呕吐发生率低于使用氟烷的患者（36%对46%，P < 0.025），但与使用恩氟烷的患者发生率相似（46%对41%）。使用异氟烷的患者止吐药需求量最少（异氟烷12%，氟烷和恩氟烷均为23%，P < 0.005），但头痛和镇痛需求量相似。
异氟烷引起的术后呕吐比氟烷少，但使用这些药物中的任何一种麻醉后头痛发生率相似。
