Trytko R L, Werschler W P
Anesthesia Associates, Spokane, Washington 99204, USA.
Lasers Surg Med. 1999;25(2):126-30. doi: 10.1002/(sici)1096-9101(1999)25:2<126::aid-lsm5>3.0.co;2-y.
Providing general anesthesia in an office-based setting can be time consuming, risky, and expensive. The purpose of this study was to describe a technique for total intravenous anesthesia (TIVA) technique that can be easily utilized by anesthesiologists in an office-based setting for laser facial resurfacing.
STUDY DESIGN/MATERIALS AND METHODS: Twenty-five American Society of Anesthesiologists (ASA) status classification I-II patients (22 females and three males) elected general anesthesia for laser facial resurfacing. All patients were premedicated with glycopyrrolate (0.2 mg IV). All anesthetics were administered by board-certified anesthesiologists, and ASA Standards for Anesthesia Monitoring were strictly followed. An induction dose of propofol (2. 0-2.5 mg/kg IV) was followed by laryngeal mask airway insertion (size 3 or 4). TIVA was maintained with a propofol infusion (50-250 mcg/kg/minute IV). Supplemental midazolam (2-4 mg IV), fentanyl (0. 05-0.20 mg IV), and oxygen (2-4 l/minute) were administered as needed. After completion of the laser procedure, TIVA was discontinued and the patients were allowed to awaken. Patients were discharged after achieving a Modified Post-Anesthetic Discharge Score of >/= 9.
Mean procedure duration was 48 +/- 21 minutes, and time to discharge after the procedure was 16 +/-6 minutes. All procedures and anesthetics were well tolerated and without complications. The only post-procedure complaint was an isolated, minor, and temporary sore throat.
TIVA is an excellent method for providing anesthesia for laser facial resurfacing in an office-based setting.
在门诊环境中实施全身麻醉可能耗时、有风险且成本高昂。本研究的目的是描述一种全静脉麻醉（TIVA）技术，该技术可供麻醉医生在门诊环境中轻松用于激光面部皮肤磨削术。
研究设计/材料与方法：25例美国麻醉医师协会（ASA）分级为I-II级的患者（22例女性和3例男性）选择全身麻醉进行激光面部皮肤磨削术。所有患者术前均静脉注射格隆溴铵（0.2mg）。所有麻醉均由具备专业资格认证的麻醉医生实施，并严格遵循ASA麻醉监测标准。静脉注射诱导剂量的丙泊酚（2.0-2.5mg/kg）后插入喉罩气道（3号或4号）。通过静脉输注丙泊酚（50-250mcg/kg/分钟）维持TIVA。根据需要静脉追加咪达唑仑（2-4mg）、芬太尼（0.05-0.20mg）和氧气（2-4升/分钟）。激光手术完成后，停止TIVA，让患者苏醒。患者在改良麻醉后出院评分≥9分时出院。
平均手术时长为48±21分钟，术后出院时间为16±6分钟。所有手术和麻醉耐受性良好，无并发症。术后唯一的主诉是孤立的、轻微的、暂时性的咽痛。
TIVA是在门诊环境中为激光面部皮肤磨削术提供麻醉的一种极佳方法。
