Postoperative recovery of patients with differential requirements for sevoflurane after abdominal surgery: A prospective observational clinical study

• Published in: Medicine (Baltimore) 2021-02, Vol.100 (8), p.e24842-e24842
• Main Authors: Li, Jia, Wei, Yi Yong, Zhang, Dong Hang
• Format: Article
• Language: English
• Subjects: Airway Extubation - adverse effects; Anesthesia Recovery Period; Anesthesia, General - methods; Anesthetics, Inhalation - administration & dosage; Anesthetics, Inhalation - pharmacokinetics; Case-Control Studies; Consciousness Monitors; Digestive System Surgical Procedures - methods; Female; Humans; Male; Middle Aged; Observational Study; Prospective Studies; Sevoflurane - administration & dosage; Sevoflurane - pharmacokinetics
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000024842

An association between animals and volatile anaesthetic requirements has been shown; however, evidence related to the postoperative outcome of human patients is lacking. Our aim was to investigate whether there is a difference in the requirement for sevoflurane among people undergoing gastrointestinal surgery.We observed 390 adult patients who underwent gastrointestinal surgery with an American Society of Anesthesiologists physical status of I or II with an expected surgery duration of > 2 hours. We used the bispectral index (BIS) to guide the regulation of end-tidal sevoflurane concentration (ETsevo). The mean ETsevo from 20 minutes after endotracheal intubation to 2 hours after the start of surgery was calculated for all patients. Differential sevoflurane requirements were identified according to ETsevo. The BIS, ETsevo, heart rate, mean arterial pressure, dose of sufentanil and cisatracurium, tracheal extubation time, incidence of intraoperative awareness, and incidence of postoperative nausea and vomiting were compared between patients with a low requirement for sevoflurane (group L) and patients with a high requirement for sevoflurane (group H).The mean ETsevo of the 390 patients was 1.55% ± 0.26%. Based on our definition, patients with an ETsevo of < 1.29% were allocated to the low requirement group (group L; n = 69), while patients with an ETsevo of > 1.81% were allocated to the high requirement group (group H; n = 78). The ETsevo of group L was significantly lower than the ETsevo of group H (1.29% ± 0.014% vs 1.82% ± 0.017%, P