Omission of fentanyl during sevoflurane anesthesia decreases the incidences of postoperative nausea and vomiting and accelerates postanesthesia recovery in major breast cancer surgery.
Omission of fentanyl during sevoflurane anesthesia decreases the incidences of postoperative nausea and vomiting and accelerates postanesthesia recovery in major breast cancer surgery.
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DOI：
10.1007/s00540-006-0413-x
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发表时间：
2006-01-01
影响因子：
2.8
通讯作者：
Fukuda, Kazuhiko
中科院分区：
文献类型：
--
作者：
Shirakami, Gotaro;Teratani, Yuriko;Fukuda, Kazuhiko
目的：探讨七氟醚麻醉中不使用芬太尼对女性乳腺癌手术患者术后恶心、呕吐发生率及术后苏醒的影响。方法：女性乳腺癌手术患者，年龄28~84岁，美国麻醉医师协会身体状况I~II级，随机分为七氟醚复合芬太尼麻醉(SF；n=25)和无芬太尼七氟醚麻醉(S，n=26)两组。所有患者均以异丙酚2 mg×kg(-1)静脉麻醉诱导，置入喉罩，行直肠双氯芬酸和局部浸润性麻醉。麻醉维持在氧气中的七氟醚中，他们自发呼吸。结果：SF组术后前24小时恶心呕吐发生率(68%比27%)和呕吐发生率(32%比8%)明显高于S组。从麻醉后监护病房(PACU)到下地活动时间的中位数(第25~75百分位数)SF组(n=23)在195分钟(158~219分钟)明显长于S组(141分钟)(101~175分钟)。SF组有2例患者在PACU期间不能行走。结论：七氟醚麻醉时不使用芬太尼，联合双氯芬酸和局部渗透麻醉，可减少术后恶心、呕吐的发生，促进麻醉后恢复。
PURPOSE: Our purpose was to investigate the effect of omission of fentanyl during sevoflurane anesthesia on the incidences of postoperative nausea and vomiting and on postanesthesia recovery in female patients undergoing major breast cancer surgery.METHODS: Female patients (American Society of Anesthesiologists [ASA] physical status [PS] class I-II; age, 28-84 years) undergoing major breast cancer surgery were randomized to one of two anesthesia maintenance groups: sevoflurane-fentanyl anesthesia (SF; n = 25) or fentanyl-free sevoflurane anesthesia (S; n = 26). All patients were administered with propofol 2 mg x kg(-1) intravenously for anesthesia induction, a laryngeal mask airway was placed, and they received rectal diclofenac and local infiltration anesthesia. Anesthesia was maintained with sevoflurane in oxygen-air and they breathed spontaneously. The patients in group SF received fentanyl 0.1 mg intravenously and those in group S received normal saline during anesthesia.RESULTS: Group SF revealed higher incidences of postoperative nausea (68% vs 27%) and vomiting (32% vs 8%) in the first 24 postoperative hours than group S. The median (25th-75th percentile) length of time from postanesthesia care unit (PACU) admission to ambulation was significantly longer in group SF (n = 23) at 195 min (158-219 min), than in group S, at 141 min (101-175 min). Two patients in group SF could not walk during the PACU stay.CONCLUSION: Omission of fentanyl during sevoflurane anesthesia, combined with diclofenac and local infiltration anesthesia, decreases the incidences of postoperative nausea and vomiting and accelerates postanesthesia recovery in patients undergoing major breast cancer surgery.