Pastuovic M N, Cohen M E, Burton R G
Oral and Maxillofacial Surgery, Naval Hospital, Great Lakes, IL, USA.
J Oral Maxillofac Surg. 1996 Aug;54(8):943-8. doi: 10.1016/s0278-2391(96)90387-0.
This study compared propofol with methohexital for use in outpatient general anesthesia for oral surgery procedures.
Fifty American Society of Anesthesia (ASA) class I or II patients undergoing elective minor oral surgery procedures were selected for inclusion in the study. Participants were randomly divided into two groups-propofol-treated and methohexital-treated. All anesthetic agents were titrated in bolus using dosages standardized by weight. After premedication with intravenous midazolam and fentanyl, general anesthesia was induced either by propofol or methohexital. The quality of the anesthesia was subjectively evaluated by the anesthetist, surgeon, and the patient. Also, a standardized battery of tests was developed to quantitatively evaluate recovery from anesthesia.
Propofol showed significantly less percentage increase in diastolic blood pressure and heart rate than methohexital. However, at the same time, propofol showed significantly greater percentage lowering of diastolic blood pressure. The mean low heart rate percentage of preoperative baseline were different, but both were greater than 100%. The anesthetist and patient evaluations showed no statistically significant difference in the acceptance of either agent. No patient in either group had any recollection of pain with induction or any recollection of the operation itself. There were no statistically significant effects of group in recovery test performance, although patients tended to recover more quickly in the symbol digit test and object recall test with propofol. No patient complained of any postoperative complications secondary to the anesthetic.
Propofol is a suitable agent for induction and maintenance of general anesthesia for outpatient oral surgery procedures. It provides a smooth induction of anesthesia with few excitatory effects.
本研究比较丙泊酚和甲己炔巴比妥用于口腔外科门诊全身麻醉的效果。
选取50例美国麻醉医师协会（ASA）分级为I或II级、接受择期小型口腔外科手术的患者纳入研究。参与者被随机分为两组——丙泊酚治疗组和甲己炔巴比妥治疗组。所有麻醉剂均按体重标准化剂量以推注方式滴定。在静脉注射咪达唑仑和芬太尼进行术前用药后，分别用丙泊酚或甲己炔巴比妥诱导全身麻醉。麻醉质量由麻醉医师、外科医生和患者进行主观评估。此外，还开发了一套标准化测试，以定量评估麻醉恢复情况。
丙泊酚组舒张压和心率的百分比增加值显著低于甲己炔巴比妥组。然而，与此同时，丙泊酚组舒张压的降低百分比显著更大。术前基线平均低心率百分比有所不同，但均大于100%。麻醉医师和患者的评估显示，两种药物的接受度在统计学上无显著差异。两组均无患者对诱导时的疼痛或手术本身有任何记忆。在恢复测试表现方面，两组之间无统计学显著影响，尽管在符号数字测试和物体回忆测试中，使用丙泊酚的患者恢复得更快。没有患者抱怨因麻醉引起的任何术后并发症。
丙泊酚是口腔外科门诊全身麻醉诱导和维持的合适药物。它能提供平稳的麻醉诱导，兴奋作用较少。
