Fredman B, Nathanson M H, Smith I, Wang J, Klein K, White P F
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas 75235-9068, USA.
Anesth Analg. 1995 Oct;81(4):823-8. doi: 10.1097/00000539-199510000-00028.
Three different anesthetic techniques were compared in 146 healthy outpatients undergoing ambulatory surgery. In Groups I and II, anesthesia was induced with propofol (1.5-2.0 mg/kg, intravenously [iv]) and maintained with nitrous oxide (N2O) 60% in oxygen and either a propofol infusion, 75-160 micrograms.kg-1.min-1 IV, or sevoflurane, 1%-2% end-tidal, respectively. In Group III, anesthesia was induced and maintained with sevoflurane, 1%-4% end-tidal and N2O 60% in oxygen. In addition to 60% N2O in oxygen at a total gas flow of 3 L/min, all patients received fentanyl, 2-3 micrograms/kg IV, and vecuronium, 0.1 mg/kg IV. IV induction of anesthesia with propofol (90 +/- 53 s and 94 +/- 48 s in Groups I and II, respectively) was significantly faster than inhalation induction with sevoflurane (153 +/- 100 s). There were no significant differences in the incidence of coughing, airway irritation, or laryngospasm during induction of anesthesia. Although the mean arterial blood pressure values were similar in all three groups, the use of sevoflurane was associated with consistently lower heart rate values during the early maintenance period. Early and intermediate recovery times were the same in all three treatment groups. The use of sevoflurane for induction and/or maintenance of anesthesia was associated with a higher incidence of postoperative emetic sequelae compared with propofol. Finally, the times at which patients were considered "fit for discharge" and the actual discharge times were similar in all three groups. Sevoflurane is an acceptable alternative to propofol for induction and maintenance of outpatient anesthesia.
在146例接受门诊手术的健康门诊患者中比较了三种不同的麻醉技术。在第一组和第二组中，静脉注射丙泊酚（1.5 - 2.0 mg/kg）诱导麻醉，并用60%氧化亚氮（N₂O）和氧气维持，第一组静脉输注丙泊酚，75 - 160微克·kg⁻¹·min⁻¹，第二组呼气末七氟醚浓度为1% - 2%。在第三组中，呼气末七氟醚浓度为1% - 4%和60%氧化亚氮与氧气维持诱导和麻醉。除了在总气体流量为3 L/min的情况下使用60%氧化亚氮与氧气外，所有患者均静脉注射芬太尼2 - 3微克/千克和维库溴铵0.1毫克/千克。丙泊酚静脉诱导麻醉（第一组和第二组分别为90±53秒和94±48秒）明显快于七氟醚吸入诱导（153±100秒）。麻醉诱导期间咳嗽、气道刺激或喉痉挛的发生率无显著差异。虽然三组的平均动脉血压值相似，但在早期维持期使用七氟醚时心率值持续较低。所有三个治疗组的早期和中期恢复时间相同。与丙泊酚相比，使用七氟醚诱导和/或维持麻醉与术后呕吐后遗症的发生率较高有关。最后，三组患者被认为“适合出院”的时间和实际出院时间相似。七氟醚是丙泊酚用于门诊麻醉诱导和维持的可接受替代药物。
