Sala X, Ayuso M A, Salvador L, Luis M, Nalda M A
Servicio de Anestesiología y Reanimación, Hospital Clínic i Provincial, Barcelona.
Rev Esp Anestesiol Reanim. 1994 Mar-Apr;41(2):93-6.
To compare two anesthetic protocols for maintenance of anesthesia during laryngectomy (propofol vs thiopental-isoflurane), assessing its effects on intraoperative hemodynamic stability and recovery time after withdrawal of anesthesia.
Thirty-one patients undergoing laryngectomy. Anesthetic technique was the same except for the maintenance anesthetic used (isoflurane in group I [n = 16]; propofol in group P [n = 15]). We recorded heart rate and systolic/diastolic arterial pressure before surgery, 10 minutes after induction, at 10, 60 and 120 min after start of surgery and at the end of the procedure. Postanesthesia recovery time was measured by the Steward test (recovery of consciousness, control of voluntary movement and of breathing) applied at 3, 5, 10, 30 and 60 min after withdrawal of anesthesia.
There were no demographic differences between the two groups and heart rate and systolic/diastolic pressures were comparable. Postanesthetic recovery time was shorter in group P than in group I, with a statistically significant difference 5 min after withdrawal of drug (p < 0.05) owing to the item recovery of consciousness in the Steward test (p < 0.05 at times 5 and 10 min for this item). There were no significant differences in control of breathing or movement.
Propofol for anesthetic maintenance is effective and safe. There are no differences in hemodynamic changes produced by propofol and isoflurane. Time until recovery of consciousness is longer with isoflurane, although we believe that this is not clinically relevant in this type of procedure.
比较两种用于喉切除术麻醉维持的方案（丙泊酚与硫喷妥钠 - 异氟烷），评估其对术中血流动力学稳定性及麻醉停药后恢复时间的影响。
31例行喉切除术的患者。除所使用的维持麻醉药物不同外（I组[n = 16]使用异氟烷；P组[n = 15]使用丙泊酚），麻醉技术相同。我们记录了手术前、诱导后10分钟、手术开始后10、60和120分钟以及手术结束时的心率和收缩压/舒张压。通过在麻醉停药后3、5、10、30和60分钟应用Steward测试（意识恢复、自主运动控制和呼吸控制）来测量麻醉后恢复时间。
两组在人口统计学方面无差异，心率及收缩压/舒张压具有可比性。P组的麻醉后恢复时间短于I组，在停药5分钟后差异有统计学意义（p < 0.05），这是由于Steward测试中的意识恢复项目所致（该项目在5分钟和10分钟时p < 0.05）。在呼吸或运动控制方面无显著差异。
丙泊酚用于麻醉维持有效且安全。丙泊酚和异氟烷产生的血流动力学变化无差异。异氟烷麻醉后意识恢复时间较长，尽管我们认为在这类手术中这在临床上并无相关性。
