方法：我们对2005年至2018年间在我院接受七氟烷或地氟烷维持全身麻醉的成人患者（非心脏手术）进行了回顾性分析。我们评估了地氟烷暴露（与七氟烷相比）与术后呼吸并发症主要结局之间的关系，定义为拔管后早期血氧饱和度降低（SpO2<90%）或术后7天内重新插管。进行多元回归分析，并调整混杂因素，包括患者、麻醉和手术因素。采用倾向性匹配、交互作用和亚组分析来评估高危组的预后：病态肥胖（BMI>35 kg.m ）、老年人（年龄>65岁）、呼吸系统并发症的高风险以及24小时的主要转归。
原始文献来源： Zucco L, Santer P, Levy N, et al. A comparison of postoperative respiratory complications associated with the use of desflurane and sevoflurane: a single-centre cohort study.[J].Anaesthesia. 2020 Aug 3.DOI：10.1111/anae.15203
A comparison of postoperative respiratory complications associated with the use of desflurane and sevoflurane: a single-centre cohort study
Sevoflurane and desflurane are the most commonly used volatile anaesthetics for maintenance of anaesthesia. In this study, we aimed to evaluate the relationship between choice of volatile anaesthetic and early postoperative respiratory complications, and to address a critical knowledge gap in safety outcomes between these two commonly used agents. We performed a retrospective analysis of adult (non-cardiac surgery) patients who received sevoflurane or desflurane for the maintenance of general anaesthesia at our institution between 2005 and 2018. We evaluated the association between desflurane exposure (when compared with sevoflurane) and the primary outcome of postoperative respiratory complications, defined by early post-extubation desaturation (SpO2 < 90%) or re-intubation within 7 days postoperatively. Multivariable regression analyses were performed and adjusted for confounding factors, including patient, anaesthetic and surgical factors. Propensity matched, interaction and sub-group analyses were performed to assess outcomes in high-risk groups: morbidly obese (BMI > 35 kg.m2 ); elderly (age > 65 years); and high risk of respiratory complications as well as the primary outcome at 24 h. Desflurane was used for 23,830 patients and sevoflurane for 84,608 patients. Patients exposed to desflurane did not demonstrate a reduced risk of postoperative respiratory complications when compared with sevoflurane (adjusted odds ratio 0.99, 95%CI 0.94–1.04, p = 0.598). These findings were consistent across all sub-groups of high-risk patients and in the propensity score matched cohort. In summary, desflurane use was not associated with reduced postoperative respiratory complications when compared with sevoflurane. In the context of environmental and cost concerns with volatile anaesthetic agents, our study provides important data to support organisational decisions regarding the use of desflurane.