Candelaria L M, Smith R K
Department of Oral and Maxillofacial Surgery, University of Tennessee, Memphis 38163.
J Oral Maxillofac Surg. 1995 Feb;53(2):124-8; discussion 129-30. doi: 10.1016/0278-2391(95)90385-2.
The purpose was to evaluate the suitability of a continuous propofol infusion in combination with alfentanil for outpatient general anesthesia in an oral and maxillofacial surgery practice.
Twenty-seven ASA 1 patients were selected to undergo oral and maxillofacial surgery outpatient procedures of short duration. Induction of anesthesia was accomplished with 1 mg/kg intravenous (i.v.) propofol and 10 micrograms/kg i.v. alfentanil. Local anesthesia was administered. General anesthesia was maintained with a continuous infusion of 150 micrograms/kg/min of propofol. Various physical and psychomotor responses were recorded during induction, maintenance, emergence, and recovery.
Anesthesia was successfully induced in all patients with single, slowly titrated, bolus doses of 1 mg/kg of propofol and 10 micrograms/kg of alfentanil. Induction of general anesthesia occurred in less than 1 minute in all cases and no excitatory phenomena, tremor, or hypertonus were observed. Maintenance of anesthesia was adequately accomplished and cardiovascular parameters remained within acceptable limits throughout the procedure. The average length of surgery was 22 minutes. Movement to surgical stimulus was minimal and easily managed with additional local anesthetic and/or a 10-mg bolus of propofol. Time to eye opening was approximately 5 minutes from the discontinuation of the propofol infusion. No emergence phenomena were observed. All patients were ready for discharge with baseline psychomotor activity within 30 minutes following the end of the procedure. The average total dose of propofol was 350 mg and the average dose of alfentanil was 750 micrograms.
This anesthetic technique has numerous advantages with minimal side effects, and should be considered for routine use for outpatient general anesthesia in oral and maxillofacial surgery.
本研究旨在评估丙泊酚持续输注联合阿芬太尼用于口腔颌面外科门诊全身麻醉的适用性。
选取27例ASA 1级患者，行短期口腔颌面外科门诊手术。静脉注射1 mg/kg丙泊酚和10 μg/kg阿芬太尼诱导麻醉。给予局部麻醉。丙泊酚以150 μg/kg/min的速度持续输注维持全身麻醉。记录诱导期、维持期、苏醒期和恢复期的各种身体和精神运动反应。
所有患者均通过单次、缓慢滴定的1 mg/kg丙泊酚和10 μg/kg阿芬太尼推注剂量成功诱导麻醉。所有病例全身麻醉诱导均在1分钟内完成，未观察到兴奋现象、震颤或肌张力亢进。麻醉维持效果良好，整个手术过程中心血管参数均保持在可接受范围内。平均手术时长为22分钟。对手术刺激的反应轻微，额外给予局部麻醉药和/或10 mg丙泊酚推注即可轻松处理。停止丙泊酚输注后约5分钟睁眼。未观察到苏醒期现象。所有患者在手术结束后30分钟内精神运动活动恢复至基线水平，准备出院。丙泊酚平均总剂量为350 mg，阿芬太尼平均剂量为750 μg。
这种麻醉技术具有诸多优点，副作用极小，应考虑用于口腔颌面外科门诊全身麻醉的常规应用。
