Jensen A G, Kalman S H, Nyström P O, Eintrei C
Department of Anaesthesiology, Faculty of Health Sciences, University Hospital Linköping, Sweden.
Can J Anaesth. 1992 Nov;39(9):938-43. doi: 10.1007/BF03008343.
The aim of this study was to evaluate the influence of propofol, nitrous oxide and isoflurane on recovery, postoperative bowel function and postoperative complications after major gastrointestinal surgery. Sixty patients undergoing elective colonic operations were included in the study. They were randomly allocated to anaesthesia with isoflurane-nitrous oxide, propofol-air, or propofol-nitrous oxide, with fentanyl and vecuronium being used in all three groups. The same anaesthetic and surgical teams performed all the operations. The postoperative course was judged once each day by the Acute Physiology Score (APS) based on the Apache II classification, passage of gas, tolerance of enteral feeding, hospital stay and complications up to 30 days after surgery. The demographic data, magnitude of operation, duration of operation, intraoperative blood loss, and post-operative analgesic needs were similar in the groups. In all groups the APS was normal by median day 1 (range 1-7). A similar impairment of bowel function after operation, with passage of gas median 3 (1-6) days after surgery and tolerance of enteral intake median day 5 (1-10), was found in all groups. The incidence of complications and the length of postoperative hospital stay, median 11 (6-45) days, did not differ among the groups. It is concluded that overall recovery, bowel function, postoperative hospital stay, and complications were not influenced by the anaesthetic technique.
本研究旨在评估丙泊酚、氧化亚氮和异氟烷对大胃肠手术后恢复、术后肠功能及术后并发症的影响。60例接受择期结肠手术的患者纳入本研究。他们被随机分配接受异氟烷 - 氧化亚氮、丙泊酚 - 空气或丙泊酚 - 氧化亚氮麻醉，三组均使用芬太尼和维库溴铵。所有手术均由同一麻醉和手术团队进行。术后过程通过基于急性生理评分（APS）的Apache II分类、排气情况、肠内营养耐受性、住院时间以及术后30天内的并发症情况每天评估一次。三组患者的人口统计学数据、手术规模、手术持续时间、术中失血及术后镇痛需求相似。所有组中，术后第1天（范围1 - 7天）APS中位数均正常。所有组术后肠功能均有类似损害，排气中位数为术后3天（1 - 6天），肠内营养耐受性中位数为术后第5天（1 - 10天）。各组并发症发生率及术后住院时间中位数为11天（6 - 45天），无差异。结论是麻醉技术对总体恢复、肠功能、术后住院时间及并发症并无影响。
