Recovery from sevoflurane anesthesia - A comparison to isoflurane and propofol anesthesia
Recovery from sevoflurane anesthesia - A comparison to isoflurane and propofol anesthesia
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DOI：
10.1097/00000542-199812000-00032
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发表时间：
1998-12-01
期刊：
影响因子：
8.8
通讯作者：
Pichotta, PJ
中科院分区：
文献类型：
--
作者：
Ebert, TJ;Robinson, BJ;Pichotta, PJ
背景资料：七氟烷的血液：气体分配系数低于异氟烷，这可能导致更快的麻醉恢复;它也可能导致比丙泊酚为基础的麻醉更快的苏醒时间。我们评估了一个数据库，该数据库包括来自Abbott Laboratories申办的对照、随机、前瞻性研究的恢复终点，这些研究比较了成年患者在完成择期手术后立即计划拔管时七氟烷与异氟烷或丙泊酚的情况。在8项研究中比较了七氟烷与异氟烷（N = 2，008）和3项研究（N = 436）中的丙泊酚，使用最小二乘法平均值进行方差分析，以计算主要麻醉剂之间恢复终点的汇总平均差异。还确定了患者年龄和病例持续时间的影响，结果：与异氟烷相比，七氟烷导致至苏醒时间（-3.3 min）、对命令的反应时间（-3.1 min）、定向时间（-4.0 min）和首次镇痛时间（-8.9 min）统计学显著缩短，但至出院资格的时间（-1.7 min）无统计学显著缩短（平均差异）。使用异氟烷时，至恢复终点的时间随着病例持续时间的增加而增加，但使用七氟烷时则不然（在持续时间超过3小时的病例中，接受异氟烷的患者比接受七氟烷的患者多花4-5分钟才能出现并对命令做出反应，多花8.6分钟才能定向），65岁以上的患者定向时间更长，但在任何年龄组中，七氟烷给药后，定向力始终更快，七氟烷和异丙酚的恢复时间没有差异结论：在所有年龄组中，七氟烷的恢复比异氟烷快3-4分钟，并且在手术时间较长的情况下（> 3小时），差异会放大。
Background: Sevoflurane has a lower blood:gas partition coefficient than isoflurane, which may cause a more rapid recovery from anesthesia; it also might cause faster emergence times than for propofol-based anesthesia. We evaluated a database that included recovery endpoints from controlled, randomized, prospective studies sponsored by Abbott Laboratories that compared sevoflurane to isoflurane or propofol when extubation was planned immediately after completion of elective surgery in adult patients.Methods: Sevoflurane was compared to isoflurane in eight studies (N = 2,008) and to propofol in three studies (N = 436), Analysis of variance was applied using least squares method mean values to calculate the pooled mean difference in recovery endpoints between primary anesthetics. The effects of patient age and case duration also were determined,Results: Sevoflurane resulted in statistically significant shorter times to emergence (-3.3 min), response to command (-3.1 min), orientation (-4.0 min) and first analgesic (-8.9 min) but not time to eligibility for discharge (-1.7 min) compared to isoflurane (mean difference). Times to recovery end points increased with increasing case duration with isoflurane but not with sevoflurane (patients receiving isoflurane took 4-5 min more to emerge and respond to commands and 8.6 min more to achieve orientation during cases longer than 3 hr in duration than those receiving sevoflurane), Patients older than 65 yr had longer times to orientation, but within any age group, orientation was always faster after sevoflurane, There were no differences in recovery times between sevoflurane and propofolConclusions: Recovery from sevoflurane was 3-4 min faster than with isoflurane in all age groups, and the difference was magnified in longer-duration surgical cases (> 3 hr).