Mishra Ld, Pradhan Sk, Pradhan Cs
Professor & Head, Division of Neuroanaesthesia, Department of Anaesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, India.
J Anaesthesiol Clin Pharmacol. 2011 Jan;27(1):59-61.
Often conventional Inhalational agents are used for maintenance of anaesthesia in spine surgery. This study was undertaken to compare propofol with isoflurane anaesthesia with regard to haemodynamic stability, early emergence, postoperative nausea and vomiting (PONV) and early assessment of neurological functions. PATIENTS #ENTITYSTARTX00026;
Eighty ASA grade I &II adult patients were randomly allocated into two groups. Patients in study group received inj propofol for induction as well as for maintenance along with N(2)O+O(2) and the control group patients received inj thiopentone for induction and N(2)O+O(2)+isoflurane for maintenance. BIS monitoring was used for titrating the anaesthetic dose adjustments in all patients. All patients received fentanyl boluses for intraoperative analgesia and atracurium as muscle relaxant. Statistical data containing haemodynamic parameters, PONV, emergence time, dose of drug consumed & quality of surgical field were recorded and compared using student t' test and Chi square test.
The haemodynamic stability was coparable in both the groups. The quality of surgical field were better in study group. Though there was no significant difference in the recovery profile (8.3% Vs 9.02%) between both the groups, the postoperative nausea and vomiting was less in propofol group than isoflurane group (25%Vs60%). The anaesthesia cost was nearly double for propofol than isoflurane anaesthesia.
Haemodynamic stability was comparable in both the groups. There was no significant difference in the recovery time between intravenous and inhalational group. Patients in propofol group were clear headed at awakening and were better oriented to place than inhalational group.
脊柱手术中通常使用传统吸入麻醉剂维持麻醉。本研究旨在比较丙泊酚和异氟烷麻醉在血流动力学稳定性、早期苏醒、术后恶心呕吐(PONV)及神经功能早期评估方面的差异。患者#实体开始X00026;
80例美国麻醉医师协会(ASA)I级和II级成年患者被随机分为两组。研究组患者诱导和维持麻醉均使用丙泊酚注射液,同时吸入N₂O + O₂,对照组患者诱导使用硫喷妥钠注射液,维持麻醉使用N₂O + O₂ + 异氟烷。所有患者均使用脑电双频指数(BIS)监测来滴定麻醉剂量调整。所有患者术中均静脉注射芬太尼镇痛,并使用阿曲库铵作为肌肉松弛剂。记录包含血流动力学参数、PONV、苏醒时间、药物消耗剂量及手术视野质量的统计数据,并使用学生t检验和卡方检验进行比较。
两组的血流动力学稳定性相当。研究组的手术视野质量更好。虽然两组之间的恢复情况无显著差异(8.3%对9.02%),但丙泊酚组的术后恶心呕吐少于异氟烷组(25%对60%)。丙泊酚麻醉的费用几乎是异氟烷麻醉的两倍。
两组的血流动力学稳定性相当。静脉麻醉组和吸入麻醉组的恢复时间无显著差异。丙泊酚组患者苏醒时头脑清醒,定向力比吸入麻醉组更好。