Randomized controlled trial of the haemodynamic and recovery effects of xenon or propofol anaesthesia
Randomized controlled trial of the haemodynamic and recovery effects of xenon or propofol anaesthesia
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DOI：
10.1093/bja/aei023
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发表时间：
2005-02-01
影响因子：
9.8
通讯作者：
Rossaint, R
中科院分区：
文献类型：
--
作者：
Coburn, M;Kunitz, O;Rossaint, R
背景氙在大量患者中的临床经验有限。我们提出了术中和术后的血流动力学和恢复数据比较氙和全静脉麻醉与丙泊酚。共有160例年龄在18-60岁（阿萨I和II）的择期手术患者参加了这项前瞻性非盲随机对照试验。在当地伦理委员会批准和书面知情同意书后，患者被随机分配到氙气组或丙泊酚组。用丙泊酚和瑞芬太尼诱导麻醉，并用氙维持在60%（最小肺泡浓度0.95）或丙泊酚0.1-0.12 mg kg（-1）min（-1）。两组均根据临床需要调整瑞芬太尼用量。两个研究组在年龄、体重、身高、性别和阿萨分级方面具有可比性。两组的基线心率和收缩期动脉压（SAP）相当。诱导后，氙组SAP最初降低，但在15分钟内恢复到基线值，与丙泊酚组有显著差异。心率仅在氙组中显著降低，并保持稳定值。两组间高血压、低血压和心动过缓的发生率和持续时间无显著差异。两组患者在麻醉后监护室的恢复时间和麻醉恢复时间相似。诱导后，氙/阿片类药物方案将收缩压维持在基线水平和低心率。麻醉期间，两组之间的血流动力学稳定性无差异。氙麻醉的恢复与丙泊酚组相似。
Background. There is limited clinical experience with xenon in a large number of patients. We present intra- and postoperative haemodynamic and recovery data comparing xenon and total intravenous anaesthesia with propofol.Methods. A total of 160 patients aged 18-60 years (ASA I and II) undergoing elective surgery took part in this prospective non-blinded randomized controlled trial. After local ethics committee approval and written informed consent, patients were allocated randomly to either the xenon or the propofol group. Anaesthesia was induced with propofol and remifentanil and was maintained with xenon at 60% (minimal alveolar concentration 0.95) or with propofol 0.1-0.12 mg kg(-1) min(-1). Remifentanil was titrated to clinical need in both groups.Results. The two study groups were comparable with respect to age, weight, height, gender and ASA classification. Baseline in heart rate and systolic arterial pressure (SAP) were comparable in both groups. Following induction, SAP initially decreased but returned to baseline values over 15 min in the xenon group and differed significantly from the propofol group. Heart rate decreased significantly only in the xenon group and remained at stable values. Occurrence and duration of hypertension, hypotension and bradycardia showed no significant difference between groups. Patient recovery time in the post-anaesthetic care unit and recovery from anaesthesia was similar in the two groups.Conclusions. After induction the xenon/opioid regimen maintains systolic blood pressure at baseline levels and a low heart rate. No differences between groups were found in haemodynamic stability during anaesthesia. Recovery from xenon anaesthesia was similar to that observed in the propofol group.