Bryson H M, Fulton B R, Faulds D
Adis International Limited, Auckland, New Zealand.
Drugs. 1995 Sep;50(3):513-59. doi: 10.2165/00003495-199550030-00008.
Propofol is an intravenous sedative hypnotic agent which rapidly and reliably causes loss of consciousness. It is also associated with a quick and 'smooth' recovery, which distinguishes it from many of the more traditional anaesthetic regimens. Like other intravenous agents, propofol is both a cardiovascular and a respiratory depressant; however, the risk of these effects can be lessened by appropriate dosage adjustment or patient management. Anaphylaxis with propofol is rare. Propofol anaesthesia in day case surgery is consistently associated with a quicker early recovery than other intravenous agents and the more traditional anaesthetic regimens. Savings in time to discharge were more variable compared with these regimens, although propofol was commonly associated with less post-operative nausea and vomiting in this period. In the future, the relative benefits of propofol compared with the newer volatile agents (desflurane and sevoflurane) and propofol/volatile agent combinations need to be examined in this clinical setting. There is now clinical experience with propofol in major surgical procedures including cardiac and neurosurgery. Propofol has also been investigated as a sedative accompanying regional or local anaesthesia for diagnostic and therapeutic procedures, and in other clinical settings (ophthalmic surgery, cardioversion and electroconvulsive therapy). The unique antiemetic, antiepileptic and antipruritic effects of propofol may further broaden its appeal. As a result of its favourable recovery profile, propofol holds a central place in day case surgery anaesthesia. Accumulating clinical experience in cardiac and neurosurgery suggests that the full potential of propofol has yet to be realised.
丙泊酚是一种静脉镇静催眠药，能迅速且可靠地使人失去意识。它还具有快速且“平稳”的恢复过程，这使其有别于许多更为传统的麻醉方案。与其他静脉用药一样，丙泊酚对心血管和呼吸系统都有抑制作用；然而，通过适当调整剂量或对患者进行管理，可以降低这些作用的风险。丙泊酚引起过敏反应的情况罕见。在日间手术中，丙泊酚麻醉始终比其他静脉用药及更为传统的麻醉方案能带来更快的早期恢复。与这些方案相比，出院时间的节省情况则更具变数，不过在此期间丙泊酚通常与较少的术后恶心和呕吐相关。未来，在这种临床环境中需要研究丙泊酚与新型挥发性麻醉剂（地氟烷和七氟烷）以及丙泊酚/挥发性麻醉剂组合相比的相对益处。目前在包括心脏手术和神经外科手术在内的大型外科手术中已有丙泊酚的临床应用经验。丙泊酚还被研究用于诊断和治疗过程中作为区域或局部麻醉时的镇静剂，以及在其他临床环境中（眼科手术、心脏复律和电休克治疗）使用。丙泊酚独特的止吐、抗癫痫和止痒作用可能会进一步扩大其应用范围。由于其良好的恢复特性，丙泊酚在日间手术麻醉中占据核心地位。在心脏手术和神经外科手术中不断积累的临床经验表明，丙泊酚的全部潜力尚未得到充分发挥。
