Recovery of cognitive function after remifentanil-propofol anesthesia: A comparison with desflurane and sevoflurane anesthesia
Recovery of cognitive function after remifentanil-propofol anesthesia: A comparison with desflurane and sevoflurane anesthesia
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DOI：
10.1097/00000539-200001000-00035
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发表时间：
2000-01-01
影响因子：
5.7
通讯作者：
Larsen, R
中科院分区：
文献类型：
--
作者：
Larsen, B;Seitz, A;Larsen, R
我们比较了瑞芬太尼、地氟烷和七氟醚用于择期手术麻醉时的苏醒特点。60例ASA分级为I级和II级的患者，年龄18-65岁，随机分为瑞芬太尼-异丙酚、地氟烷-N2O或七氟醚-N2O麻醉。地氟醚组和七氟醚组在麻醉诱导前给予芬太尼2 mg/kg。所有组用异丙酚诱导麻醉，瑞芬太尼0.25ug·kg(-1)·min(-1)、地氟烷或七氟醚0.85MAC加65%一氧化二氮维持。对麻醉药进行滴定，以达到适当的手术麻醉水平，并将平均动脉压维持在基线的20%以内。记录早期恢复时间和改良的Aldrete恢复评分>；9。在手术前一天和麻醉后护理病房分别进行Trieger点试验和数字替代试验(DSST)，以评估中期恢复情况。瑞芬太尼-异丙酚组的苏醒时间明显快于地氟醚或七氟醚，两种吸入麻醉剂之间没有差异。麻醉后30min，瑞芬太尼-异丙酚组和地氟醚组的DST反应正确率明显高于七氟醚组(瑞芬太尼87%，地氟烷83%，七氟醚56%)，七氟醚组的损伤程度与血液酒精水平的影响相当。约为0.1%，因此具有临床重要性。给药90min后，各组间的DSST评分差异无统计学意义。麻醉后60min，瑞芬太尼-异丙酚组认知功能恢复明显快于地氟醚和七氟醚。提示：我们比较了瑞芬太尼-异丙酚麻醉与地氟烷-N2O和七氟醚-N2O麻醉后的苏醒时间和中位苏醒时间。麻醉后60min，瑞芬太尼-异丙酚组认知功能恢复明显快于地氟醚和七氟醚。
We compared the recovery characteristics of remifentanil, desflurane, and sevoflurane when used for anesthesia in elective operative procedures. Sixty ASA physical status I and II patients, aged 18-65 yr, were randomly assigned to receive remifentanil-propofol, desflurane-N2O, or sevoflurane-N2O anesthesia. Before the induction of anesthesia, the patients of the desflurane and sevoflurane groups received fentanyl 2 mu g/kg. In all groups, anesthesia was induced with propofol and maintained either with remifentanil 0.25 mu g.kg(-1).min(-1), desflurane, or sevoflurane 0.85 MAC with 65% nitrous oxide in oxygen. Anesthetics were titrated to achieve an adequate level of surgical anesthesia and to maintain mean arterial pressure within 20% of baseline values. Early recovery times and a modified Aldrete Recovery Score > 9 were recorded. Trieger Dot Test and Digit Substitution Test (DSST) were performed the day before surgery and in the postanesthesia care unit to evaluate intermediate recovery. The remifentanil-propofol group had a significantly faster emergence than desflurane or sevoflurane, with no difference between both inhaled anesthetics. Thirty min after anesthesia administration, patients in the remifentanil-propofol and in the desflurane groups gave significantly more correct responses in the DSST compared with sevoflurane (remifentanil 87%, desflurane 83%, sevoflurane 56%), the impairment in the sevoflurane patients corresponding to the effects of a blood alcohol level. of approximately 0.1% and, thus, being of clinical importance. Ninety minutes after anesthesia administration, no significant difference could be demonstrated among the groups in the DSST scores. Emergence and return of cognitive function was significantly faster after remifentanil-propofol compared with desflurane and sevoflurane up to 60 min after anesthesia administration. Implications: We compared awakening and intermediate recovery times after remifentanil-propofol anesthesia to desflurane-N2O and sevoflurane-N2O anesthesia. Emergence and return of cognitive function was significantly faster after remifentanil-propofol compared with desflurane and sevoflurane up to 60 min after anesthesia administration.