MULTICENTER STUDY OF GENERAL-ANESTHESIA .2. RESULTS

被引:156
作者
FORREST, JB
CAHALAN, MK
REHDER, K
GOLDSMITH, CH
LEVY, WJ
STRUNIN, L
BOTA, W
BOUCEK, CD
CUCCHIARA, RF
DHAMEE, S
DOMINO, KB
DUDMAN, AJ
HAMILTON, WK
KAMPINE, J
KOTRLY, KJ
MALTBY, JR
MAZLOOMDOOST, M
MACKENZIE, RA
MELNICK, BM
MOTOYAMA, E
MUIR, JJ
MUNSHI, C
机构
[1] MAYO CLIN & MAYO FDN,DEPT ANESTHESIOL,200 1ST ST SW,ROCHESTER,MN 55905
[2] MCMASTER UNIV,HAMILTON L8S 4L8,ONTARIO,CANADA
[3] MED COLL WISCONSIN,MILWAUKEE,WI 53226
[4] UNIV CALIF SAN FRANCISCO,SAN FRANCISCO,CA 94143
[5] UNIV CALGARY,CALGARY T2N 1N4,ALBERTA,CANADA
[6] UNIV PITTSBURGH,PITTSBURGH,PA 15260
[7] UNIV PENN,PHILADELPHIA,PA 19104
关键词
Anesthetics; intravenous:fentanyl; volatile:enflurane; halothane; isoflurance; Epidemiology: outcome; prospective study; randomization;
D O I
10.1097/00000542-199002000-00009
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
A prospective, stratified, randomized clinical trial of the safety and efficacy of four general anesthetic agents (enflurane, fentanyl, halothane, and isoflurane) was conducted in 17,201 patients (study population). Patients were studied before, during, and after anesthesia for up to 7 days. Nineteen patients died (0.11%), and in seven of these (0.04%) the anesthetic may have been a contributing factor. The rates of death, myocardial infarction, and stroke in the study population were so low (less than 0.15%) that no conclusions regarding the relative rates of these outcomes among the four anesthetic agents could be reached. The rates of 16 of 66 types of adverse outcomes in the study population were significantly different among the four study agents. Most of these outcomes were minor. However, severe ventricular arrhythmia (P<10-6) was more common with halothane, severe hypertension (P<10-6) and severe bronchospasm (P=0.028) were more common with fentanyl, and severe tachycardia (P=0.001) was more common with isoflurane. Recovery from anesthesia during the first 30 min was slowest in those patients who received halothane (P≤0.001). In addition, patients who received fentanyl experienced less pain during the first hour in the recovery room (P<10-6). In conclusion, clinically important differences do exist for some outcomes among the four study agents.
引用
收藏
页码:262 / 268
页数:7
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