与七氟烷麻醉相比，地氟醚麻醉使接受甲状腺手术的成年患者更易出现躁动。
本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见
Desflurane anesthesia worsens emergence agitation in adult patients undergoing thyroid surgery compared to sevoflurane anesthesia.
背景与目的
挥发性麻醉药对成人出现躁动的影响尚不清楚。 我们比较了在接受甲状腺手术的成人中使用地氟醚和七氟醚麻醉出现兴奋的程度。
方 法
将116位ASA分级1或2级的患者随机分为两组：地氟烷组（D组）和七氟醚组（S组）。用芬太尼（1-2μg/ kg）和丙泊酚（1.5-2.5mg / kg）诱导麻醉后，用琥珀胆碱（0.5-1.0mg / kg）保证气管插管。D组维持地氟烷在%66的笑气及33%的氧气中，必要时补充芬太尼。在S组中，使用七氟醚代替地氟醚。手术结束后拔管前使用改良的麻醉诱导谵妄评分（范围从0至16，分数越高表示出现更严重的出现躁动）评估出现的兴奋程度。评估手术结束至拔管的时间、术后疼痛（通过数字评分量表[NRS评估]）和手术后恶心呕吐（PONV）
结 果
D组出现兴奋程度比S组严重（中位数[四分位间距]：5 [4-7] vs 4 [2-6]，p = 0.008）。拔管时间、两组lNRS评分和PONV发生率相似。
结 论
接受甲状腺手术的成年患者与地氟醚麻醉相比，地氟醚麻醉加剧了出现躁动，但并未影响拔管时间，术后疼痛或PONV。
原始文献摘要
Suzuki T, Kurazumi T, Ueda T, et al. Desflurane anesthesia worsens emergence agitation in adult patients undergoing thyroid surgery compared to sevoflurane anesthesia[J]. Ja Clinical Reports, 2017, 3(1):36.
BACKGROUND:
The effect of volatile anesthetics on emergence agitation in adults remains unclear. We compared the degree of emergence agitation between desflurane and sevoflurane anesthesia in adults undergoing thyroid surgery.
FINDINGS:
One hundred and sixteen patients with American Society of Anesthesiologists status 1 or 2 were randomized into two groups: the desflurane group (group D) and the sevoflurane group (group S). After induction of anesthesia with fentanyl (1-2 μg/kg) and propofol (1.5-2.5 mg/kg), tracheal intubation was facilitated with suxamethonium (0.5-1.0 mg/kg). In group D, anesthesia was maintained with desflurane in 66% nitrous oxide and 33% oxygen supplemented with fentanyl when necessary; in group S, sevoflurane was used instead of desflurane. After the end of the surgery, emergence agitation was evaluated with a modified pediatric anesthesia emergence delirium scale (ranging from 0 to 16, with higher scores indicating more severe emergence agitation) before extubation. Time to extubation from the end of the surgery, postoperative pain (evaluated by a numerical rating scale [NRS]), and postoperative nausea and vomiting (PONV) after surgery were examined.
RESULTS:
The degree of emergence agitation was more severe in group D than in group S (median [interquartile range]: 5 [4-7] vs 4 [2-6], p = 0.008). Time to extubation, NRS scores, and PONV rates were similar between the two groups.
CONCLUSIONS:
Desflurane anesthesia worsened emergence agitation as compared with sevoflurane in adult patients undergoing thyroid surgery, but did not affect time to extubation, postoperative pain, or PONV.
麻醉学文献进展分享