DATASET OF "Impact of short-acting vs. standard anaesthetic agents on obstructive sleep apnoea: a randomised, controlled, triple-blind trial"

Sleep apnoea is associated with negative outcomes following general anaesthesia. Current recommendations suggest using short-acting anaesthetic agents in preference to standard agents to reduce this risk, but there is currently no evidence to support this. This randomised controlled triple-blind trial tested the hypothesis that a combination of short-acting agents (desflurane-remifentanil) would reduce the postoperative impact of general anaesthesia on sleep apnoea severity compared with standard agents (sevoflurane-fentanyl). Sixty patients undergoing hip arthroplasty under general anaesthesia were randomised to anaesthesia with desflurane-remifentanil or sevoflurane-fentanyl. Respiratory polygraphy was performed before surgery and on the first and third postoperative nights. The primary outcome was the supine apnoea-hypopnoea index on the first postoperative night. Secondary outcomes were the supine apnoea-hypopnoea index on the third postoperative night, and the oxygen desaturation index on the first and third postoperative nights. Additional outcomes included intravenous morphine equivalent consumption and pain scores on postoperative days 1, 2 and 3. Pre-operative sleep study data were similar between groups. Mean (95%CI) values for the supine apnoea-hypopnoea index on the first postoperative night were 18.9 (12.7–25.0) and 21.4 (14.2–28.7) events.h^-1, respectively, in the short-acting and standard anaesthesia groups (p=0.64). Corresponding values on the third postoperative night were 28.1 (15.8–40.3) and 38.0 (18.3–57.6) events.h^-1 (p=0.34). Secondary sleep- and pain-related outcomes were generally similar in the two groups. In conclusion, short-acting anaesthetic agents did not reduce the impact of general anaesthesia on sleep apnoea severity compared with standard agents. These data should prompt an update of current recommendations.睡眠呼吸暂停（sleep apnoea）与全身麻醉（general anaesthesia）术后不良预后密切相关。当前临床推荐优先选用短效麻醉剂以降低此类风险，但目前尚无循证医学证据支持这一做法。本项随机对照三盲试验（randomised controlled triple-blind trial）验证了下述假说：与标准麻醉剂组合（七氟烷-芬太尼，sevoflurane-fentanyl）相比，短效麻醉剂组合（地氟烷-瑞芬太尼，desflurane-remifentanil）可减轻全身麻醉术后睡眠呼吸暂停严重程度的恶化程度。 本研究共纳入60名接受全身麻醉下髋关节置换术（hip arthroplasty）的患者，按随机原则分为地氟烷-瑞芬太尼组与七氟烷-芬太尼组。分别于术前、术后第一及第三晚实施呼吸多导睡眠监测（respiratory polygraphy）。主要结局指标为术后第一晚的仰卧位呼吸暂停-低通气指数（apnoea-hypopnoea index）；次要结局指标为术后第三晚的仰卧位呼吸暂停-低通气指数，以及术后第一、第三晚的氧减饱和度指数（oxygen desaturation index）。额外结局指标涵盖术后第1、2、3天的静脉注射吗啡等效消耗量（morphine equivalent consumption）与疼痛评分。 两组患者术前睡眠监测数据无显著差异。短效麻醉组与标准麻醉组术后第一晚的仰卧位呼吸暂停-低通气指数均值（95%置信区间）分别为18.9（12.7~25.0）次·小时⁻¹与21.4（14.2~28.7）次·小时⁻¹（p=0.64）；术后第三晚的对应数值分别为28.1（15.8~40.3）次·小时⁻¹与38.0（18.3~57.6）次·小时⁻¹（p=0.34）。两组间其余睡眠相关及疼痛相关结局指标总体无统计学差异。 最终结论显示：与标准麻醉剂相比，短效麻醉剂并未减轻全身麻醉对睡眠呼吸暂停严重程度的不良影响。本研究数据应推动当前相关临床推荐的更新。