Grabow L, Hein A, Hendrikx B, Thiel W, Schilling E
Anasth Intensivther Notfallmed. 1986 Aug;21(4):181-6.
600 patients were given 6 different premedications in randomised design to study their effect on the course of anaesthesia and on postoperative pain. Premedication acts indirectly on anaesthesia, depending on the influence of the drug on anxiety and on the somatic correlates of anxiety. The greater the sedative-anxiolytic effect of the premedication, the easier it is to induce anaesthesia, and the more superficial the anaesthesia, resulting in earlier and stronger onset of postoperative pain. On the other hand, the more anxious the patient is, the more he consumes anaesthetic drugs, whereas anaesthesia remains superficial with the same consequences in respect of postoperative pain. In view of postoperative pain, fast and early awakening from anaesthesia must not be aimed at, particularly after operations which definitely result in postoperative pain (long-term operations in those regions of the body that cannot be immobilised).
600名患者被随机分配接受6种不同的术前用药，以研究它们对麻醉过程和术后疼痛的影响。术前用药对麻醉的作用是间接的，这取决于药物对焦虑以及焦虑的躯体相关因素的影响。术前用药的镇静 - 抗焦虑作用越强，诱导麻醉就越容易，麻醉也越浅，从而导致术后疼痛更早、更强烈地发作。另一方面，患者越焦虑，消耗的麻醉药物就越多，而麻醉仍较浅，对术后疼痛会产生相同的后果。鉴于术后疼痛，尤其在那些肯定会导致术后疼痛的手术（身体无法固定的部位进行的长时间手术）后，不应追求快速和早期从麻醉中苏醒。
