Steib A, Freys G, Jochum D, Ravanello J, Schaal J C, Otteni J C
Department of Anaesthesiology, University Hospital Hautepierre, Strasbourg, France.
Acta Anaesthesiol Scand. 1990 Nov;34(8):632-5. doi: 10.1111/j.1399-6576.1990.tb03161.x.
The aim of this study was to compare recovery assessed with the Newman, deletion af a's and postbox tests after total intravenous anaesthsia for procedures lasting more than 90 min, with either propofol (PPF) or midazolam (MDZ), reversed or not by flumazenil (FMZ). Thirty patients scheduled for peripheral surgery were randomly allocated to 3 groups of 10, receiving by continuous infusion until the end of surgery either PPF (n = 10) or MDZ (n = 20) combined with alfentanil. FMZ was administered thereafter to 10 patients receiving MDZ until they opened their eyes on command or to a maximum dose of 1 mg. Recovery tests were performed 45, 90 and 180 min after the end of anaesthesia. Results were analysed with non-parametric tests. Recovery scores were significantly better in the PPF group at all times, reaching control values at 180 min for the three first tests. FMZ reversal did not improve the scores compared to those resulting from MDZ alone. This study provides further data in favour of PPF as far as rapid and complete recovery is concerned. The efficiency of FMZ is incomplete and only transient when administered in a single dose.
本研究旨在比较丙泊酚（PPF）或咪达唑仑（MDZ）用于持续时间超过90分钟的手术的全静脉麻醉后，采用纽曼、删去a's和邮箱测试评估的恢复情况，氟马西尼（FMZ）是否对其进行逆转。30例计划进行外周手术的患者被随机分为3组，每组10例，持续输注PPF（n = 10）或MDZ（n = 20）联合阿芬太尼直至手术结束。之后对10例接受MDZ的患者给予FMZ，直至他们按指令睁眼或最大剂量达1毫克。在麻醉结束后45、90和180分钟进行恢复测试。结果采用非参数检验进行分析。PPF组在所有时间点的恢复评分均显著更好，前三项测试在180分钟时达到对照值。与单独使用MDZ相比，FMZ逆转并未改善评分。就快速和完全恢复而言，本研究提供了进一步支持PPF的数据。单剂量使用FMZ时，其效果不完全且只是短暂的。
