Pollard B J, Bryan A, Bennett D, Faragher E B, Un E N, Keegan M, Wilson A, Burkill M, Beatty P C, Stollery B T
University Department of Anaesthesia, Manchester Royal Infirmary.
Br J Anaesth. 1994 May;72(5):559-66. doi: 10.1093/bja/72.5.559.
We have compared the recovery characteristics of four different techniques for maintenance of anaesthesia in 99 day-case patients admitted for oral surgery. All patients received propofol for induction of anaesthesia followed by halothane, enflurane, isoflurane or propofol infusion for maintenance of anaesthesia. Each patient was subjected to a battery of psychometric tests which included Spielberger state, trait, mood stress and mood arousal questionnaires, Maddox-Wing test and five-choice serial reaction time. All tests were performed before operation and at 0.5, 1, 2, 4, 24 and 48 h after operation. Performance in the reaction time test decreased significantly in the immediate postoperative period, returning almost to preoperative values by 4 h. However, only those patients who received enflurane or propofol had returned to their performance level before surgery by 4 h, although all four groups had achieved this target by 24 h. There was a further improvement in performance at 48 h. Anxiety and stress were high before surgery and decreased rapidly in the postoperative period. The Maddox-Wing test demonstrated a significant impairment in performance in the first 1 h after surgery, which returned to normal by discharge at 4 h. There were no significant differences between the four groups in these latter tests.
我们比较了99例接受口腔外科手术的日间手术患者采用四种不同麻醉维持技术后的恢复特征。所有患者均接受丙泊酚诱导麻醉，随后分别采用氟烷、恩氟烷、异氟烷或丙泊酚输注进行麻醉维持。每位患者都接受了一系列心理测试，包括斯皮尔伯格状态、特质、情绪应激和情绪唤醒问卷、马多克斯-温氏试验以及五选连续反应时测试。所有测试均在手术前以及术后0.5小时、1小时、2小时、4小时、24小时和48小时进行。反应时测试的表现术后即刻显著下降，4小时时几乎恢复到术前水平。然而，只有接受恩氟烷或丙泊酚的患者在4小时时恢复到了手术前的表现水平，尽管所有四组在24小时时都达到了这一目标。48小时时表现进一步改善。术前焦虑和应激水平较高，术后迅速下降。马多克斯-温氏试验显示术后第1小时表现显著受损，4小时出院时恢复正常。在这些后期测试中，四组之间没有显著差异。
