Kashtan H, Edelist G, Mallon J, Kapala D
Department of Anaesthesia, Mount Sinai Hospital, University of Toronto, Ontario.
Can J Anaesth. 1990 Mar;37(2):170-6. doi: 10.1007/BF03005465.
Sixty unpremedicated ASA physical status I or II patients scheduled for surgical procedures of intermediate duration (15 to 60 min) were studied to evaluate the safety and efficacy of propofol, to measure recovery times and to compare the return of psychomotor and cognitive function with thiopentone. Patients were randomly allocated into two groups. Anaesthesia was induced and maintained by either propofol (2.0-2.5 mg.kg-1 followed by a continuous infusion 0.1-0.2 mg.kg-1.min-1) or thiopentone (4.0-5.0 mg.kg-1, and infusion rate 0.16-0.32 mg.kg-1.min-1), titrated to patient response. Succinylcholine was administered to facilitate tracheal intubation and maintain neuromuscular blockade. Induction of anaesthesia was slightly longer with propofol than thiopentone (42.2 vs 29.8 sec) and was smooth with both drugs. Post-intubation increases in heart rate, and systolic and diastolic blood pressures were attenuated by propofol when compared with thiopentone. After the administration of propofol, times to eye opening (6.4 +/- 4.3 vs 13.9 +/- 15.9 min), response to verbal command (7.6 +/- 6.3 vs 15.4 +/- 16.6 min) and orientation (22.7 +/- 12.8 vs 36.2 +/- 23.1 min), were significantly shorter. Psychomotor and cognitive function returned earlier with propofol and fewer side effects were noted. At 24 hr there was no distinguishable difference between groups. Propofol is a safe anaesthetic agent with the potential for early patient discharge and street fitness after outpatient procedures.
选取60例计划接受中等时长（15至60分钟）外科手术的未使用术前药的美国麻醉医师协会（ASA）身体状况为I或II级的患者，以评估丙泊酚的安全性和有效性，测量恢复时间，并比较其与硫喷妥钠在精神运动和认知功能恢复方面的情况。患者被随机分为两组。分别用丙泊酚（2.0 - 2.5mg·kg⁻¹，随后持续输注0.1 - 0.2mg·kg⁻¹·min⁻¹）或硫喷妥钠（4.0 - 5.0mg·kg⁻¹，输注速率0.16 - 0.32mg·kg⁻¹·min⁻¹）诱导和维持麻醉，根据患者反应进行滴定。给予琥珀酰胆碱以利于气管插管并维持神经肌肉阻滞。丙泊酚诱导麻醉的时间比硫喷妥钠略长（42.2秒对29.8秒），两种药物诱导过程均平稳。与硫喷妥钠相比，丙泊酚可减轻插管后心率、收缩压和舒张压的升高。给予丙泊酚后，睁眼时间（6.4±4.3分钟对13.9±15.9分钟）、对言语指令的反应时间（7.6±6.3分钟对15.4±16.6分钟）和定向时间（22.7±12.8分钟对36.2±23.1分钟）明显更短。丙泊酚使精神运动和认知功能恢复更早，且副作用更少。24小时时两组之间无明显差异。丙泊酚是一种安全的麻醉剂，具有使患者在门诊手术后早期出院并恢复正常活动的潜力。
