McGregor R R, Allan L G, Sharpe R M, Thornton C, Newton D E
Academic Department of Anaesthetics, Imperial College of Science, Technology and Medicine, Northwick Park Hospital, Harrow.
Br J Anaesth. 1998 Nov;81(5):785-6. doi: 10.1093/bja/81.5.785.
We have observed the effect of intubation and incision, as measured by the auditory evoked response (AER) and haemodynamic variables, in 12 patients undergoing hernia repair or varicose vein surgery who received remifentanil as part of either an inhaled anaesthetic technique using isoflurane or as part of a total i.v. technique using propofol. Anaesthesia was induced with remifentanil 1 microgram kg-1 and propofol, neuromuscular block was achieved with atracurium 0.6 mg kg-1 before intubation, and anaesthesia was maintained with a continuous infusion of remifentanil in combination with either a continuous infusion of propofol or inhaled isoflurane. The AER and haemodynamic variables were measured before and after intubation and incision. The effects of intubation and incision on the AER and haemodynamic variables were not significantly different between the remifentanil-propofol and remifentanil-isoflurane groups. However, the study had a low power for this comparison. When the data for the two anaesthetic combinations were pooled, the only significant effects were increases in diastolic arterial pressure and heart rate immediately after intubation; these were not seen 5 min after intubation. There were no cardiovascular responses to incision. There were no significant changes in the AER after intubation or incision.
我们观察了12例接受疝修补术或静脉曲张手术患者在插管和切开时的效果，通过听觉诱发电位（AER）和血流动力学变量进行测量。这些患者接受瑞芬太尼，其作为使用异氟烷的吸入麻醉技术的一部分，或作为使用丙泊酚的全静脉技术的一部分。用1微克/千克瑞芬太尼和丙泊酚诱导麻醉，插管前用0.6毫克/千克阿曲库铵实现神经肌肉阻滞，并用瑞芬太尼持续输注联合丙泊酚持续输注或吸入异氟烷维持麻醉。在插管和切开前后测量AER和血流动力学变量。瑞芬太尼-丙泊酚组和瑞芬太尼-异氟烷组之间，插管和切开对AER和血流动力学变量的影响无显著差异。然而，该研究在进行此比较时效能较低。当将两种麻醉组合的数据合并时，唯一显著的影响是插管后即刻舒张压和心率升高；插管5分钟后未见此现象。切开时无心血管反应。插管或切开后AER无显著变化。
