Perioperative incidence of airway obstructive and hypoxemic events in patients with confirmed or suspected sleep apnea - a prospective, randomized pilot study comparing propofol/remifentanil and sevoflurane/remifentanil anesthesia.
Perioperative incidence of airway obstructive and hypoxemic events in patients with confirmed or suspected sleep apnea - a prospective, randomized pilot study comparing propofol/remifentanil and sevoflurane/remifentanil anesthesia.
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气道阻塞性和缺氧事件的围手术期发生率是确认或疑似睡眠呼吸暂停的患者 - 一项前瞻性的，随机的试验研究，比较了丙泊酚/雷利芬太尼和Sevoflurane/sevoflurane/remifentanil麻醉。
DOI：
10.1186/s12871-018-0477-9
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发表时间：
2018-01-27
影响因子：
2.2
通讯作者：
Peters J
中科院分区：
文献类型：
--
作者：
Fassbender P;Bürgener S;Haddad A;Silvanus MT;Peters J
阻塞性睡眠呼吸暂停（OSA）是围手术期并发症的危险因素，但麻醉方案的数据很少。在确诊或高度怀疑OSA的患者中，我们采用前瞻性随机设计评估了丙泊酚/瑞芬太尼或七氟烷/瑞芬太尼麻醉对夜间呼吸暂停低通气指数（AHI）和血氧饱和度（SpO 2）的影响。根据OSA病史和/或STOP -问卷阳性选择患者，并使用瑞芬太尼（12 μg/kg/h）联合丙泊酚（4-6 mg/kg/h，n = 27）或七氟烷（约10 mg/kg/h）进行全身麻醉。2.2 vol%潮气末，n = 27）。于麻醉前、后夜间测定AHI和SpO 2。麻醉方案之间以及术前和术后夜间之间的AHI无差异（丙泊酚：8.6 h− 1（中位数，CI：3.6-21.9）vs. 7.9 h− 1（1.8-28.8）; p = 0.97;七氟烷：3.8 h− 1（1.8-7.3）vs. 2.9 h− 1（1.2-9.5）; p = 0.85）。术后最低SpO 2（丙泊酚：80.7% ± 4.6，七氟烷：81.6 ± 4.6）与其各自的术前基线（丙泊酚：79.6% ± 6.5; p = 0.26，七氟烷：80.8% ± 5.2; p = 0.39）无差异。即使在麻醉前AHI > 15的患者中，术后夜间AHI保持不变。因此，在一组疑似或确诊OSA的患者中，当与短效阿片类药物瑞芬太尼联合使用时，挥发性药物七氟烷或静脉麻醉剂丙泊酚均未改变夜间AHI或氧饱和度。德国临床试验注册中心，DRKS 00005824于2014年3月12日进行回顾性注册。
Obstructive sleep apnea (OSA) is a risk factor for perioperative complications but data on anesthesia regimen are scarce. In patients with established or strongly suspected OSA, we assessed in a prospective, randomized design the effects on nocturnal apnea-hypopnea-index (AHI) and oxygen saturation (SpO2) of propofol/remifentanil or sevoflurane/remifentanil based anesthesia. Patients were selected by a history for OSA and / or a positive STOP – questionnaire and received general anesthesia using remifentanil (12 μg/kg/h) combined either with propofol (4-6 mg/kg/h, n = 27) or sevoflurane (approx. 2.2 vol% endtidal, n = 27). AHI and SpO2 were measured during the nights before and after anesthesia. There were no differences in AHI between anesthetic regimens nor between the pre- and postoperative nights (propofol: 8.6 h− 1 (median, CI: 3.6–21.9) vs. 7.9 h− 1 (1.8–28.8); p = 0.97; sevoflurane: 3.8 h− 1 (1.8–7.3) vs. 2.9 h− 1 (1.2–9.5); p = 0.85). Postoperative minimum SpO2 (propofol: 80.7% ± 4.6, sevoflurane: 81.6 ± 4.6) did not differ from their respective preoperative baselines (propofol: 79.6% ± 6.5; p = 0.26, sevoflurane: 80.8% ± 5.2; p = 0.39). Even in patients with a preanesthetic AHI > 15, nocturnal AHI remained unchanged postoperatively. Thus, in a cohort of patients with suspected or confirmed OSA undergoing surgery of moderate duration and severity neither the volatile agent sevoflurane nor the intravenous anesthetic propofol altered nocturnal AHI or oxygen saturation, when combined with the short acting opioid remifentanil. German Clinical Trials Register, DRKS00005824 retrospectively registered on 03/12/2014.
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影响因子：
4.3
作者：
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通讯作者：
Bradley, T. Douglas
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