Lindekaer A L, Skielboe M, Guldager H, Jensen E W
Department of Anaesthesiology, Herlev Hospital, University of Copenhagen, Denmark.
Anaesthesia. 1995 May;50(5):397-9. doi: 10.1111/j.1365-2044.1995.tb05991.x.
We studied the influence of nitrous oxide on the maintenance dose of propofol and recovery characteristics in 42 patients, aged 18-62 years, ASA 1 or 2, scheduled for day case inguinal herniotomy. Using a double-blind, randomised design, patients received anaesthesia with propofol-alfentanil-vecuronium-oxygen and either nitrous oxide or room air (FIO2 = 0.30). The rate of propofol infusion was adjusted depending on anaesthetic depth as judged using standard clinical criteria; alfentanil was administered on a weight basis. Patients' lungs were manually ventilated after tracheal intubation and muscle relaxation was reversed at the end of surgery with neostigmine and atropine. A series of psychomotor tests was performed pre-operatively and 30 and 120 min postoperatively. The mean maintenance doses of propofol were 0.084 mg.kg-1.min-1 in the N2O group and 0.088 mg.kg-1.min-1 in the air group (p = 0.97). In the nitrous oxide group the mean (SD) interval to spontaneous eye opening was 13.1 (7.3) min compared to 8.1 (4.9) min in the air group (p = 0.01). Similarly, the interval until obtaining a standardised response was 13.5 (5.3) min and 9.8 min (5.4) in the nitrous oxide and air groups, respectively (p = 0.04). The addition of nitrous oxide to propofol-alfentanil-vecuronium anaesthesia does not reduce propofol requirements and prolongs early recovery compared to air.
我们研究了氧化亚氮对42例年龄在18至62岁、美国麻醉医师协会（ASA）分级为1或2级、计划行日间腹股沟疝修补术患者丙泊酚维持剂量及恢复特征的影响。采用双盲随机设计，患者接受丙泊酚-阿芬太尼-维库溴铵-氧气麻醉，同时吸入氧化亚氮或空气（吸入氧分数FIO2 = 0.30）。根据使用标准临床标准判断的麻醉深度调整丙泊酚输注速率；阿芬太尼按体重给药。气管插管后手动通气，手术结束时用新斯的明和阿托品逆转肌肉松弛。术前、术后30分钟和120分钟进行了一系列精神运动测试。氧化亚氮组丙泊酚的平均维持剂量为0.084mg·kg-1·min-1，空气组为0.088mg·kg-1·min-1（p = 0.97）。氧化亚氮组平均（标准差）自主睁眼时间为13.1（7.3）分钟，而空气组为8.1（4.9）分钟（p = 0.01）。同样，氧化亚氮组和空气组达到标准化反应的时间分别为13.5（5.3）分钟和9.8（5.4）分钟（p = 0.04）。与空气相比，在丙泊酚-阿芬太尼-维库溴铵麻醉中添加氧化亚氮不会降低丙泊酚需求量，反而会延长早期恢复时间。
