Volunteer Faculty, Department of Anesthesia, Keck School of Medicine, University of Southern California, Los Angeles, California.
Semin Plast Surg. 2007 May;21(2):129-32. doi: 10.1055/s-2007-979214.
Propofol is the nearly ideal agent for office-based plastic surgery. Among all anesthetic agents, only propofol has the ability to elicit happiness in this special group of patients. Cosmetic surgery patients will tolerate discomfort in preference to postoperative nausea and vomiting. Propofol is a powerful antiemetic agent. Patient safety will not be optimized unless the person responsible for the administration of propofol has airway management skills. Dedicated anesthesia providers are highly skilled in airway management. Although the short half-life of propofol is seductive for a fast-acting, rapid emerging anesthetic, interindividual differences in propofol response make measurement of the target organ (i.e., the brain) with a bispectral index (BIS) monitor very important. BIS levels < 45 for > 1 hour are associated with increased 1-year anesthesia mortality thought to be associated with an inflammatory response. The only currently available way to avoid overmedicating with propofol is to monitor with a level of consciousness monitor like BIS.
异丙酚是门诊整形手术中近乎理想的药物。在所有麻醉药物中，只有异丙酚有能力在这群特殊的患者中引起愉悦感。美容手术患者会选择忍受不适，而不是术后恶心和呕吐。异丙酚是一种强大的止吐药。除非负责异丙酚给药的人具备气道管理技能，否则患者的安全无法得到优化。专门的麻醉提供者在气道管理方面具有高度的技能。尽管异丙酚的半衰期短，适合快速作用、快速苏醒的麻醉，但个体间对异丙酚的反应存在差异，这使得使用双频谱指数（BIS）监测仪测量靶器官（即大脑）非常重要。BIS 水平 <45 持续超过 1 小时与 1 年麻醉死亡率增加相关，据认为这与炎症反应有关。目前避免异丙酚过度用药的唯一方法是使用意识监测仪（如 BIS）进行监测。
