Intravenous Lipid Emulsion Improves Recovery Time and Quality from Isoflurane Anaesthesia: A Double‐Blind Clinical Trial
Intravenous Lipid Emulsion Improves Recovery Time and Quality from Isoflurane Anaesthesia: A Double‐Blind Clinical Trial
复制标题
静脉脂质乳剂可改善异氟烷麻醉的恢复时间和质量：双盲临床试验
DOI：
10.1111/bcpt.12223
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发表时间：
2014
影响因子：
3.1
通讯作者：
Jingyu Zhang
中科院分区：
文献类型：
--
作者：
Qian Li;Di Yang;Jin Liu;Han Zhang;Jingyu Zhang
全身麻醉后的恢复时间和质量对患者的安全很重要。本研究旨在确定静脉注射脂肪乳剂是否能改善成人患者在异氟醚麻醉下接受腹腔镜胆囊切除术后的恢复情况。共纳入66例患者。麻醉诱导后，调整吸入异氟醚浓度，以维持稳定的生命体征和适宜的手术条件。手术结束时停用异氟醚，静脉注射30%脂肪乳剂2ml/kg或生理盐水2ml/kg。记录患者睁眼时间、拔管时间和离开手术室时间，并评价麻醉恢复质量。60名患者完成了这项研究。脂肪乳组睁眼和离开手术室的中位时间明显短于生理盐水组[分别为15.5(四分位数范围9.0)和20.0(10.0)分钟，P=0.01；19.5(8.3)和23.6(6.3)分钟，P=0.04]，而拔管的中位时间无明显差异。在嗜睡视觉模拟评分(p<；0.01)、观察者警觉/镇静评分(p<；0.01)、简易精神状态检查评分(p=0.04)和改良Aldrete麻醉后恢复评分(p=0.03)方面，脂肪乳组恢复质量均优于生理盐水组。在研究期间没有观察到严重的不良反应。结论：静脉注射脂肪乳剂能有效地提高异氟醚麻醉后的苏醒时间和质量。
Recovery time and quality after general anaesthesia is important for patient safety. This study aimed to determine whether intravenous lipid emulsion could improve recovery profiles from isoflurane anaesthesia in adult patients undergoing laparoscopic cholecystectomy. Sixty‐six patients were enrolled. After anaesthesia induction, inspired isoflurane concentration was adjusted to maintain stable vital signs and the suitable conditions for operation. At the end of the operation, the isoflurane was discontinued, and either 2 ml/kg 30% lipid emulsions or 0.9% saline solution was administered intravenously. The time to eye opening, extubation and exit from the operation room was recorded, and the quality of recovery from anaesthesia was assessed. Sixty patients completed the study. The median time to eye opening and exit from the operation room was significantly shorter in the lipid emulsion group than in the saline group [15.5 (interquartile range 9.0) versus 20.0 (10.0) min., p = 0.01; 19.5 (8.3) versus 23.6 (6.3) min., p = 0.04, respectively], whereas the median time to extubation did not show any noticeable difference. The quality of recovery was better in the lipid emulsion group than that of the saline solution group with respect to drowsiness visual analogue scale score (p < 0.01), Observer's Assessment of Alertness/Sedation score (p < 0.01), Mini‐Mental State Examination score (p = 0.04) and Modified Aldrete Post Anaesthesia Recovery score (p = 0.03). No serious adverse events were observed during the study period. In conclusion, intravenous lipid emulsion may effectively improve the recovery time and quality from isoflurane anaesthesia for laparoscopic cholecystectomy.