[O2 uptake in the recovery period. The effect of the anesthetic procedure and the postoperative administration of pethidine].
General anesthesia leads to a marked reduction in oxygen uptake (VO2), but during the recovery period O2 consumption can increase dramatically. A controversial discussion has continued in the literature concerning the role of different types of anesthesia with regard to metabolic changes. The aim of this comparative study was to evaluate the effects of two different techniques for general anesthesia and of postoperative meperidine on VO2, especially in the postanesthetic recovery period.


METHODS
Twelve patients (K1: ASA class I-II, age: 39.9 +/- 16.1 years, height: 176 +/- 10.1 cm, weight: 76 +/- 12.8 kg) scheduled for urological lower abdominal surgery were given isoflurane-N2O-O2 (1.3 MAC); another group of 12 patients (K2: ASA class I-II, 35.9 +/- 14.5 years, 181.8 +/- 11.4 cm, 77.3 +/- 8.4 kg) received total intravenous anesthesia (TIVA) with propofol and alfentanil (ED95). Both groups were studied under steady-state conditions. Duration of anesthesia was 124.2 +/- 27.5 min (K2) versus 139.2 +/- 35.5 min (K1). VO2 was measured by an indirect calorimetric device (MMC Horizon, STPD).


RESULTS
Preanesthetic values of VO2 were in the predicted range for basal metabolism. Steady-state general anesthesia led to approximately 30% reduction in VO2 (K1: 121-225 ml min, K2: 107-230 ml/min) compared to preanesthetic values (P less than 0.05). Both groups showed an increase in VO2 during the recovery period. When compared to the preanesthetic measurements, only K1 showed a statistically significant change. Shivering was observed during the recovery period in 8 patients in K1 (max VO2: 639 ml min) and 2 in K2 (max VO2: 584 ml min (P less than 0.05). Meperidine (25 mg i.v.) given to 5 patients from K1 because of postanesthetic shivering decreased VO2 significantly to the range of VO2 measured in K2.


CONCLUSIONS
Oxygen consumption during general anesthesia was not defined by the type of anesthetic administered. During the recovery period however, VO2 depended on the type of anesthetic, as muscular hyperactivity was prominent in the isoflurane group. Meperidine could suppress visible shivering and reduce postoperative VO2 to the levels seen after TIVA.
Hausmann
D
D
Institut für Anaesthesiologie der Rheinischen Friedrich-Wilhelms-Universität Bonn.
Nadstawek
J
J
Krajewski
W
W
D000328:Adult; D000368:Aged; D015760:Alfentanil / Q000008:administration & dosage; D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage; D008614:Meperidine / Q000494:pharmacology*; D008875:Middle Aged; D009609:Nitrous Oxide / Q000008:administration & dosage; D010101:Oxygen Consumption / Q000187:drug effects / Q000502:physiology*; D015742:Propofol / Q000008:administration & dosage
D015760:Alfentanil; D008614:Meperidine; D007530:Isoflurane; D009609:Nitrous Oxide; D015742:Propofol
O2-Aufnahme in der Aufwachphase. Einfluss des Narkoseverfahrens und der postoperativen Pethidingabe.