Sevoflurane for induction and maintenance of anesthesia in thyroidectomy

Objective To observe the efficacy of sevoflurane for the induction and maintenance of anesthesia in thyroidectomy,and discuss the safety and effectiveness of solely inhaled sevoflurane in minor surgery for adults. Methods A total of 47 patients undergoing elective thyroidectomy,with ASA physical status Ⅰ- Ⅱ,were enrolled into this study. The induction of anesthesia was performed in all patients with high-flow sevoflurane inhalation combined with sufentanil and cisatracurium,and the anesthesia was maintained with sevoflurane and sufentanil. The time to the transient loss of consciousness,time for the induction of anesthesia,time to recovery of consciousness and removal of laryngeal mask airway were recorded,and the intraoperative haemodynamics and use of vasoactive drugs were observed. The intraoperative awareness and incidence of postoperative nausea and vomiting were followed up. Results The 45 in 47 patients underwent successfully the surgery without using vasoactive substances. The time to the transient loss of consciousness was(55. 76 ±14. 02)s,time for the induction of anesthesia was(2. 82 ±0. 33) min,time to recovery of consciousness was(2. 08 ±0. 76)min,and time to removal of laryngeal mask airway was(5. 50 ±1. 06) min. The changes of hemodynamics in different time point:the systolic pressure,diastolic pressure and heart rate in 5 min after intubation was significantly lower than baseline blood pressure(BBP) and baseline heart rate(BHR) index(P < 0. 05). HR increased significantly at the removal of laryngeal mask airway as compared with BHR(P < 0. 05),however,BP increased not obviously(P > 0. 05). There was no significant change in HR and BP during the induction and skin incision(P > 0. 05). The follow up at 24 h after the operation showed that the incidence of postoperative nausea and vomiting of level 0 was 44. 4%(20 cases),of level 1 was35. 6%(16 cases),of level 2 was 20%(9 cases). The antiemetic was administrated in 2 cases(4. 4%). All patients were discharged in 2 to 3 days after the operation. Conclusion The stable anesthesia state can be achieved by using sevoflurane for the induction and maintenance of anesthesia in thyroidectomy,with the advantage of less time for recovery of consciousness. However,more experiments should be carried to explore the application of sevoflurane in the induction and maintenance of anesthesia in adults.