Nadstawek J, Hausmann D, Schüttler J, Lauven P M, Födisch M
Institut für Anästhesiologie, Rheinische Friedrich-Wilhelms-Universität Bonn.
Anasth Intensivther Notfallmed. 1990 Oct;25(5):322-6.
Recovery of motor and mental functions were investigated in two groups with 20 young patients each. One group received total intravenous anaesthesia (TIVA) with propofol and alfentanil for urological surgery and the other group received nitrous oxide-oxygen anaesthesia in combination with 1.3 MAC of enflurane for lumbar nucleotomy. The following parameters were investigated before and up to 100 minutes after extubation: simple and discriminating motor activities, vigilance and short and long term memory. --Simple and in discriminating motor actions show a significantly faster recovery was seen in the TIVA group during the first 20 minutes after extubation compared to the enflurane-treated patients. Speech-related functions were particularly inhibited in the inhalational anaesthesia group. After 30 to 40 minutes the propofol-alfentanil group was able to meet all requirements while patients with inhalational anaesthesia needed 80 minutes to reach the same level. Recovery of short and long-term memory was also significantly shorter in the TIVA group. This clearly indicates a faster return of mental and motor functions following total intravenous anaesthesia with propofol and alfentanil. However the large dosages of alfentanil may be a problem with regard to post-anaesthetic respiratory depression. Further studies with larger numbers of patients will be necessary to evaluate the potential side effects of continuous propofol/alfentanil infusion. Presently, safety demands require, at least a sixty-minute post anaesthesia monitoring for patients receiving this new anaesthesia method.
对两组各20名年轻患者的运动和精神功能恢复情况进行了研究。一组在泌尿外科手术中接受丙泊酚和阿芬太尼的全静脉麻醉(TIVA),另一组在腰椎间盘切除术时接受氧化亚氮 - 氧气麻醉并联合1.3 MAC的安氟醚。在拔管前及拔管后长达100分钟内对以下参数进行了研究:简单和辨别性运动活动、警觉性以及短期和长期记忆。——与接受安氟醚治疗的患者相比,TIVA组在拔管后的前20分钟内简单和辨别性运动动作的恢复明显更快。吸入麻醉组与言语相关的功能受到特别抑制。30至40分钟后,丙泊酚 - 阿芬太尼组能够满足所有要求,而吸入麻醉患者需要80分钟才能达到相同水平。TIVA组短期和长期记忆的恢复也明显更短。这清楚地表明丙泊酚和阿芬太尼全静脉麻醉后精神和运动功能恢复更快。然而,大剂量阿芬太尼可能在麻醉后呼吸抑制方面存在问题。需要对更多患者进行进一步研究以评估丙泊酚/阿芬太尼持续输注的潜在副作用。目前,出于安全要求,接受这种新麻醉方法的患者至少需要进行60分钟的麻醉后监测。