Linnemann M U, Guldager H, Nielsen J, Ibsen M, Hansen R W
Department of Anaesthesia, Herlev Hospital, University of Copenhagen, Denmark.
Acta Anaesthesiol Scand. 1993 Jan;37(1):29-32. doi: 10.1111/j.1399-6576.1993.tb03593.x.
The purpose of this study was to compare the frequency of psychomimetic reactions after 24 h and 3 months following total intravenous anaesthesia with propofol and neurolept anaesthesia. Forty otherwise healthy female patients were randomly divided into two groups. All were undergoing elective gynaecological laparotomy for non-malignant disease. Nineteen patients were anaesthetized with droperidol, fentanyl, pancuronium, N2O/O2. Twenty patients received total intravenous anaesthesia with propofol, fentanyl and pancuronium. Twenty-four hours after the anaesthesia the patients were interviewed about their subjective experiences of anaesthesia and recovery. Three months after the operation the patients were sent a questionnaire concerning ability to work, sleep and memory disorders. After 24 h the anaesthesia was judged as good by 18 patients receiving propofol and 13 patients receiving NLA (n.s.). The recovery was judged as good by 16 patients in the propofol group and six patients in the NLA group (P < 0.05). Locked-in feelings were reported by one patient in the propofol group and ten patients in the NLA group (P < 0.01). Impairment of memory was reported by one patient in the propofol group and seven patients in the NLA group (P < 0.01). A questionnaire used after 3 months was answered by 18 patients in the propofol group and 17 patients in the NLA group. There were few complaints, and no differences were found between the two groups. In conclusion, total intravenous anaesthesia with propofol seems more acceptable than anaesthesia with neurolept as judged by the patients 24 h after anaesthesia. There were no differences between the two groups concerning psychomimetic reactions 3 months after anaesthesia.
本研究旨在比较丙泊酚全静脉麻醉和神经安定麻醉后24小时及3个月时拟精神病反应的发生率。40名其他方面健康的女性患者被随机分为两组。所有患者均因非恶性疾病接受择期妇科剖腹手术。19名患者接受氟哌利多、芬太尼、潘库溴铵、N2O/O2麻醉。20名患者接受丙泊酚、芬太尼和潘库溴铵全静脉麻醉。麻醉后24小时，对患者进行访谈，了解他们对麻醉和恢复的主观感受。术后3个月，向患者发送一份关于工作能力、睡眠和记忆障碍的问卷。24小时后，18名接受丙泊酚麻醉的患者和13名接受神经安定麻醉的患者认为麻醉效果良好（无统计学差异）。丙泊酚组16名患者和神经安定麻醉组6名患者认为恢复良好（P<0.05）。丙泊酚组1名患者和神经安定麻醉组10名患者报告有闭锁感（P<0.01）。丙泊酚组1名患者和神经安定麻醉组7名患者报告有记忆损害（P<0.01）。3个月后，丙泊酚组18名患者和神经安定麻醉组17名患者回答了问卷。投诉很少，两组之间未发现差异。总之，根据麻醉后24小时患者的判断，丙泊酚全静脉麻醉似乎比神经安定麻醉更易被接受。麻醉后3个月，两组在拟精神病反应方面无差异。
