全麻结束前由七氟烷转为短期使用地氟烷对患者苏醒和康复的影响：一项随机对照试验

全麻结束前由七氟烷转为短期使用地氟烷对患者苏醒和康复的影响：一项随机对照试验

贵州医科大学     麻醉与心脏电生理课题组

翻译：邓举  编辑：张中伟  审核：曹莹

罂 粟 摘 要 

背景：虽然七氟烷和地氟烷被认为是可快速诱导和苏醒的吸入麻醉剂，但以往的研究表明，地氟烷麻醉比七氟烷麻醉在肥胖和老年患者术后恢复方面具有优势。我们研究了在七氟烷麻醉结束时短期切换七氟烷到地氟烷是否能提高非肥胖患者的术后恢复情况。

方法：我们将择期手术患者（n=60)随机分为两组：七氟烷麻醉组（S组，n= 30)和七氟烷地氟烷组（SD组，n= 30）。S组患者仅接受七氟醚麻醉，直到手术结束（>2小时）。在SD组中，在七氟烷麻醉完成前（约30分钟），停止七氟烷改用地氟烷麻醉。

结果：我们评估了组间睁眼时间、拔管时间，以及双谱指数为80（BIS-80）的时间之间的差异。与S组相比，SD组睁眼的时间明显缩短（438 ± 101vs295 ± 45 s；平均差143 s；95%可信区间[CI]，101-183；p < 0.001），拔管时间（476 ± 108vs312 ± 42 s；平均差164 s；95%CI，116-220；p < 0.001）和BIS-80 时间(378 ± 124vs265 ± 49分钟；平均差113 s；95% CI，58-168，p < 0.001）也明显缩短。术后恶心、呕吐、缺氧发生率各组间无差异。

结论：我们的结果表明，在七氟烷麻醉结束时，短期内（约30分钟）七氟烷转换为地氟烷可以促进患者术后恢复的速度。

原始文献来源：Ji Wook Kim, Jeong Yup Lee, Si Won Hwang,et al. The Effects of Switching from Sevoflurane to Short-Term Desflurane prior to the End of General Anesthesia on Patient Emergence and Recovery: A Randomized Controlled Trial.［J］BioMed Research International(2022) 1-9. 

英文原文 

The Effects of Switching from Sevoflurane to Short-Term

Desflurane prior to the End of General Anesthesia on Patient Emergence and Recovery: A Randomized Controlled Trial

Abstract

While sevoflurane and desflurane have been regarded as inhalation agents providing rapid induction and emergence, previous studies demonstrated the superiority of desflurane-anesthesia compared to sevoflurane-anesthesia in the postoperative recovery in obese and geriatric patients. We investigated whether a short-term switch of sevoflurane to desflurane at the end of

sevoflurane-anesthesia enhances patient postoperative recovery profile in non-obese patients. We randomly divide patients undergoing elective surgery (n = 60) into two groups: sevoflurane-anesthesia group (Group-S, n = 30) and sevofluranedesflurane group (Group-SD, n = 30). In Group-S, patients received only sevoflurane-anesthesia until the end of surgery (for >2 hours). In Group-SD, sevoflurane was stopped and switched to desflurane-anesthesia before the completion of sevofluraneanesthesia (for approximately 30 minutes). We assessed the intergroup differences in the times to get eye-opening, extubation, and a bispectral index of 80 (BIS-80). Group-SD showed significantly shorter times to get eye-opening (438 ± 101 vs. 295 ± 45

s; mean difference, 143 s; 95% confidence interval [CI], 101–183; p < 0:001), extubation (476 ± 108 vs. 312 ± 42 s; mean difference, 164 s; 95% CI, 116–220; p < 0:001), and BIS-80 (378 ± 124 vs. 265 ± 49 minutes; mean difference, 113 s; 95% CI, 58– 168 p < 0:001) compared to Group-S. There was no between-group difference in postoperative nausea, vomiting, and hypoxia incidences. Our results suggested that the short-term (approximately 30 minutes) switch of sevoflurane to desflurane at the end of sevoflurane-anesthesia can facilitate the speed of postoperative patient recovery.