Ti L K, Pua H L, Lee T L
Department of Anaesthesia, National University Hospital, Singapore.
Can J Anaesth. 1998 Oct;45(10):949-53. doi: 10.1007/BF03012302.
To evaluate whether isoflurane is as suitable as sevoflurane for the single vital capacity breath (VCB) method of inhalational induction in patients premedicated with midazolam.
A randomised, controlled, double-blind study involving 67 ASA I-II patients aged between 18-50 yr undergoing elective surgery under general anaesthesia. All participants received premedication with 0.03 mg.kg-1 midazolam i.v. Using a primed circle absorber circuit, inhalational induction of anaesthesia was performed with the single VCB method using either isoflurane 3.5% or sevoflurane 7.5% in nitrous oxide 67% in oxygen, representing approximately equivalent MAC-multiples of 3.6 MAC. Isoflurane was compared with sevoflurane in terms of rapidity, efficacy, safety and acceptability of induction.
With the single VCB method, sevoflurane produced a faster (45 +/- 21 vs 71 +/- 22 sec, P < 0.01), more successful (100% vs 75.8%, P < 0.01) induction of anaesthesia, with fewer induction-related complications (11.8% vs 84.8%, P < 0.01) than did isoflurane. There was also greater patient acceptability of induction with sevoflurane (76.4% vs 42.4%, P < 0.05).
In adults given midazolam premedication, isoflurane is not as suitable as sevoflurane for single VCB inhalational anaesthetic induction technique as it is associated with slower, more complicated induction and less patient acceptability.
评估异氟烷与七氟烷在接受咪达唑仑预处理的患者单次肺活量呼吸（VCB）吸入诱导法中是否同样适用。
一项随机、对照、双盲研究，纳入67例年龄在18至50岁之间、接受全身麻醉下择期手术的ASA I-II级患者。所有参与者静脉注射0.03 mg·kg-1咪达唑仑进行预处理。使用预充式循环吸收回路，采用单次VCB法，在67%氧化亚氮和氧气中分别使用3.5%异氟烷或7.5%七氟烷进行麻醉诱导，二者代表约3.6倍MAC的等效MAC倍数。比较异氟烷与七氟烷在诱导速度、效果、安全性和可接受性方面的差异。
采用单次VCB法时，七氟烷诱导麻醉的速度更快（45±21秒对71±22秒，P<0.01）、成功率更高（100%对75.8%，P<0.01），且诱导相关并发症更少（11.8%对84.8%，P<0.01）。七氟烷诱导的患者可接受性也更高（76.4%对42.4%，P<0.05）。
在接受咪达唑仑预处理的成年人中，异氟烷对于单次VCB吸入麻醉诱导技术不如七氟烷适用，因为它与更慢、更复杂的诱导以及更低的患者可接受性相关。
