Bol'shedvorov R V
Anesteziol Reanimatol. 2009 Nov-Dec(6):73-6.
Outpatient surgery presents a number of specific requirements for anesthesia, among which there is safety and that the main point is anesthesia, as well as postanesthesia depression should not be a limiting factor on discharge the patient from hospital. The authors compare 3 current anesthetic methods available in our country: 1) combined general anesthesia based on ketamine, dormicun, and fentanyl, 2) total venous anesthesia (TVA) based on propofol and fentanyl, and 3) anesthesia with sevorane inhalation with preserved spontaneous respiration through a laryngeal mask. Analysis of postoperative cognitive disorders and complications, such as postoperative nausea and vomiting makes combined general anesthesia be excluded from the methods suitable for outpatient operations. TVA and sevorane inhalation anesthesia show comparable results in emergence rate tests, and postanesthetic rehabilitation, the number of postoperative complications. However, less cost and amazing predictability enable the authors to prefer inhalation anesthesia.
门诊手术对麻醉提出了一些特殊要求,其中包括安全性,主要在于麻醉,以及麻醉后苏醒延迟不应成为患者出院的限制因素。作者比较了我国目前可用的三种麻醉方法:1)基于氯胺酮、多美康和芬太尼的复合全身麻醉,2)基于丙泊酚和芬太尼的全静脉麻醉(TVA),以及3)通过喉罩保留自主呼吸的七氟醚吸入麻醉。对术后认知障碍和并发症(如术后恶心和呕吐)的分析使得复合全身麻醉被排除在适合门诊手术的方法之外。在苏醒率测试、麻醉后恢复以及术后并发症数量方面,全静脉麻醉和七氟醚吸入麻醉显示出相当的结果。然而,成本较低且可预测性惊人使作者更倾向于吸入麻醉。