The influence of gender on loss of consciousness with sevoflurane or propofol
The influence of gender on loss of consciousness with sevoflurane or propofol
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DOI：
10.1213/01.ane.0000154534.71371.4f
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发表时间：
2005-08-01
影响因子：
5.7
通讯作者：
Sebel, PS
中科院分区：
文献类型：
--
作者：
Kodaka, M;Johansen, JW;Sebel, PS
研究表明，全身麻醉和苏醒所需的催眠药物可能受性别的影响。在这项研究中，我们研究了性别对使用挥发性（七氟烷）或IV（丙泊酚）麻醉剂的意识丧失（EEG）催眠需求的影响。115例未经术前用药、阿萨身体状态I-II级、年龄18-40岁的患者在自主呼吸时通过面罩接受七氟烷至预定的潮气末浓度（%ETsevo）或通过靶控输注（效应部位）接受丙泊酚。在足够的平衡时间后，通过对轻度刺激缺乏反应来评估刺激。采用狄克逊的升降法测定50%响应时催眠药的靶浓度（LOC 50）。七氟烷组男性和女性的LOC 50无统计学显著差异（分别为0.83% +/- 0.1%和0.92% +/- 0.09% ET）。男性比女性需要更多的丙泊酚（分别为2.9 +/- 0.2和2.7 +/- 0.1 μ g/mL）。然而，无论使用哪种催眠麻醉剂，男性或女性的脑电双频指数（BIS）在麻醉后均无差异。本研究发现，使用丙泊酚而非七氟烷时，男性和女性在LOC 50时的催眠需求存在较小的统计学显著性差异。根据BIS的定义，男性和女性在LOC 50时具有相同的催眠状态，表明性别对催眠需求没有临床显著影响。然而，七氟烷组和丙泊酚组在确定的临床终点（LOC 50）时的BIS存在显著差异，表明这些麻醉剂的神经生理作用可能不同。
Studies have suggested that hypnotic requirements for general anesthesia and emergence may be influenced by gender. In this study, we examined the effect of gender on the hypnotic requirement for loss of consciousness (LOC) using either a volatile (sevoflurane) or an IV (propofol) anesthetic. One-hundred-fifteen unpremedicated, ASA physical status I-II patients, aged 18-40 yr old, received either sevoflurane by mask to a predetermined end-tidal concentration (%ETsevo) or propofol by target-controlled infusion (effect site) while breathing spontaneously. After sufficient time for equilibration, LOC was assessed by lack of response to mild prodding. The up-down method of Dixon was used to determine the hypnotic target concentration at 50% response (LOC50). No statistically significant difference in LOC50 was noted between men and women for sevoflurane (0.83% +/- 0.1% and 0.92% +/- 0.09% ET, respectively). Men required significantly more propofol than women (2.9 +/- 0.2 versus 2.7 +/- 0.1 mu g/mL, respectively). However, there was no difference in the bispectral index (BIS) at LOC for men or women with either hypnotic anesthetic. This investigation identified a small, statistically significant difference in hypnotic requirement at LOC50 between men and women with propofol but not with sevoflurane. As defined by BIS, men and women had equivalent hypnotic states at LOC50, indicating that gender had no clinically significant effect on hypnotic requirements. However, BIS at a defined clinical end-point (LOC50) was significantly different between the sevoflurane and propofol groups, suggesting that neurophysiological effects of these anesthetics may be different.