Jakobsson J, Oddby E, Rane K
Department of Anaesthesia and Intensive Care, Karolinska Institute, Danderyds Hospital, Stockholm, Sweden.
Anaesthesia. 1993 Nov;48(11):1005-7. doi: 10.1111/j.1365-2044.1993.tb07485.x.
We studied 200 female patients (ASA group 1) scheduled for termination of pregnancy under general anaesthesia. The patients were randomly allocated to receive one of four anaesthetic combinations; (1) propofol in combination with ketamine 20 mg, (2) propofol in combination with fentanyl 0.1 mg, (3) thiopentone in combination with fentanyl 0.1 mg, (4) methohexitone in combination with fentanyl 0.1 mg. All patients were breathing oxygen in nitrous oxide 1:2. Patients' self assessments of per- and postoperative course and time to discharge were compared. No patient's response suggested light anaesthesia, but dreams were frequently experienced during anaesthesia especially among the propofol-ketamine combination (29 out of 50). Time to discharge was shortest for the groups of patients given propofol; the mean time was 93 and 96 min for the ketamine and fentanyl groups respectively. During the recovery period significantly more patients experienced pain in the ketamine-propofol group. Complaints of nausea were seen in only 15 patients, and seven patients noted psycho-mimetic side effects during recovery, without any differences between the groups. All four combinations tested offered good conditions for short outpatient procedures. However, the propofol-fentanyl combination was found to offer the best quality of anaesthesia as assessed by the patients themselves.
我们研究了200例计划在全身麻醉下终止妊娠的女性患者（ASA 1级）。患者被随机分配接受四种麻醉组合之一：（1）丙泊酚联合20毫克氯胺酮；（2）丙泊酚联合0.1毫克芬太尼；（3）硫喷妥钠联合0.1毫克芬太尼；（4）美索比妥联合0.1毫克芬太尼。所有患者均吸入1:2的氧化亚氮和氧气。比较了患者对围手术期和术后过程以及出院时间的自我评估。没有患者的反应提示麻醉过浅，但麻醉期间经常出现梦境，尤其是在丙泊酚-氯胺酮组合组（50例中有29例）。丙泊酚组患者的出院时间最短；氯胺酮组和芬太尼组的平均出院时间分别为93分钟和96分钟。在恢复期，氯胺酮-丙泊酚组有更多患者出现疼痛。仅15例患者出现恶心主诉，7例患者在恢复过程中出现拟精神副作用，各组合组之间无差异。所测试的四种组合均为短时间门诊手术提供了良好条件。然而，根据患者自身评估，丙泊酚-芬太尼组合的麻醉质量最佳。
