Delogu G, Tomasello C, Tellan G, Pennacchiotti M L, Marandola M, Vecchia P
Istituto di Anestesiologia e Rianimazione, Università degli Studi di Roma, La Sapienza, Roma.
Minerva Chir. 1995 Oct;50(10):863-9.
Two anaesthetic managements for elective laparoscopic cholecystectomy were compared in 64 patients in order to investigate some perioperative complications: 1) bowel distension during surgery. 2) recovery from anaesthesia. 3) post-surgery incidence of emesis and pain. In addition, the quality of postoperative peristalsis as well as the time of dimissal were recorded. Group I (n = 30) was treated with NLA in N2O-O2 and Group II (n = 34) received propofol plus fentanyl in air-O2. Bowel distension, evaluated by surgeon at 15 min intervals throughout the operation was similar in both the groups as well as postoperative peristalsis recuperation. During the first 12 hours after laparoscopy no differences were found at any times of observation in the incidence or severity of emesis and pain between the two different anaesthesia patients. In subjects which were given propofol the psychomotor recovery was more rapid than after NLA, particularly during the first 6 hours after surgery. The patients were discharged between 36-48 hours following the operation independently from anaesthetic management. It is concluded that both the anaesthetic techniques provide similar intra/postoperative conditions, except the early recovery that is more rapid for the propofol patients. The overall frequency of emesis and pain was rather high in both the groups, suggesting a routine medication with analgesics and antiemetics.
为研究一些围手术期并发症,对64例择期腹腔镜胆囊切除术患者的两种麻醉管理方法进行了比较:1)手术期间的肠扩张。2)麻醉恢复情况。3)术后呕吐和疼痛的发生率。此外,还记录了术后肠蠕动的质量以及出院时间。第一组(n = 30)在N₂O - O₂中接受NLA治疗,第二组(n = 34)在空气 - O₂中接受丙泊酚加芬太尼治疗。在整个手术过程中,外科医生每隔15分钟评估一次肠扩张情况,两组的肠扩张情况以及术后肠蠕动恢复情况相似。在腹腔镜检查后的前12小时内,在任何观察时间点,两种不同麻醉患者的呕吐和疼痛发生率及严重程度均无差异。接受丙泊酚治疗的患者精神运动恢复比接受NLA后更快,尤其是在术后的前6小时。患者在手术后36 - 48小时出院,与麻醉管理无关。结论是,两种麻醉技术提供了相似的术中和术后条件,除了丙泊酚组患者的早期恢复更快。两组呕吐和疼痛的总体发生率都相当高,这表明需要常规使用镇痛药和止吐药。