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椎管手术中丙泊酚与美索比妥的比较

[Propofol versus methohexital in the surgery of the spinal canal].

作者信息

Destribats B, Maurette P, Castagnera L, Esposito J, Macouillard G, Cantin P, Héraut L A

出版信息

Ann Fr Anesth Reanim. 1987;6(4):301-5. doi: 10.1016/s0750-7658(87)80045-x.

Abstract

The aim of this study was to compare the quality of postanaesthetic recovery after anaesthesia with methohexitone (M) or with propofol (P). Thirty patients undergoing spinal surgery were randomly assigned to either group. The induction dose was 2 mg . kg-1 for both M and P. Anaesthesia was maintained by continuous infusion. The rate was 0.15 mg . kg-1 . min-1 for P and 0.07 mg . kg-1 . min-1 for M. Analgesia was obtained with fentanyl with the same doses in both groups. The maintenance doses were subsequently decreased by 50 and 75% of the initial values. This work compared the quality induction and the criteria of recovery (Aldrete score, Newman test). In two patients in each group, sensory evoked potentials (SEP) were recorded to monitor neurological integrity. The quality of induction was similar in both groups. Awakening was significantly more rapid in group P. The SEP were much decreased in group P, whilst there were few changes in group M. Monitoring of medullar integrity is mandatory in spinal surgery, requiring a rapid recovery. This objective was obtained with shorter delays in patients anaesthetized with propofol than in those who had received methohexitone. However, the former, at the doses used, seemed to depress the SEP.

摘要

本研究旨在比较美索比妥(M)或丙泊酚(P)麻醉后麻醉复苏的质量。30例接受脊柱手术的患者被随机分为两组。M组和P组的诱导剂量均为2mg·kg-1。麻醉通过持续输注维持。P组的输注速率为0.15mg·kg-1·min-1,M组为0.07mg·kg-1·min-1。两组均使用相同剂量的芬太尼进行镇痛。随后维持剂量分别降低初始值的50%和75%。本研究比较了诱导质量和复苏标准(Aldrete评分、纽曼试验)。每组两名患者记录感觉诱发电位(SEP)以监测神经完整性。两组的诱导质量相似。P组苏醒明显更快。P组SEP明显降低,而M组变化不大。脊柱手术中必须监测髓质完整性,要求快速恢复。使用丙泊酚麻醉的患者比接受美索比妥的患者恢复延迟更短,达到了这一目标。然而,在所用剂量下,前者似乎会抑制SEP。

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