Tramèr M R, Fuchs-Buder T, Sansonetti A, Rifat K
Department of Anaesthesiology, Clinical Pharmacology and Surgical Intensive Care, University Hospital Geneva, Switzerland.
Can J Anaesth. 1997 Aug;44(8):830-5. doi: 10.1007/BF03013159.
To investigate the incidence of the oculocardiac reflex (OCR), and of postoperative nausea and vomiting (PONV) in adults undergoing strabismus surgery.
Adults (18-86 yr) undergoing inpatient strabismus surgery received 10 micrograms.kg-1 atropine and 10 micrograms.kg-1 altentanil iv and were randomly allocated to: (A) 5 mg.kg-1 thiopentone iv, isoflurane/N2O maintenance; (B) 3 mg.kg-1 propofol iv, propofol/N2O maintenance (10-14 mg.kg-1.hr-1); 3 mg.kg-1 propofol iv, propofol/air/O2 maintenance (10-14 mg.kg-1.hr-1). Analyses were with the number-needed-to-treat/harm.
In 97 adults the absolute risk of OCR (13-20%) and PONV (21-31% after 24 hr) was low, with no differences between groups. Number-needed-to-treat to prevent PONV with propofol with or without N2O compared with thiopentone-isoflurane was 7 to 11. Number-needed-to-harm for one OCR with propofol compared with thiopentone-isoflurane was 17.
Adults undergoing strabismus surgery with prophylactic atropine had a low risk of OCR and PONV, independent of the anaesthetic technique used.
调查斜视手术成年患者眼心反射（OCR）及术后恶心呕吐（PONV）的发生率。
接受住院斜视手术的成年患者（18 - 86岁）静脉注射10微克/千克阿托品和10微克/千克阿芬太尼，然后随机分为：（A）静脉注射5毫克/千克硫喷妥钠，异氟烷/氧化亚氮维持麻醉；（B）静脉注射3毫克/千克丙泊酚，丙泊酚/氧化亚氮维持麻醉（10 - 14毫克/千克·小时-1）；静脉注射3毫克/千克丙泊酚，丙泊酚/空气/氧气维持麻醉（10 - 14毫克/千克·小时-1）。采用需治疗人数/伤害人数进行分析。
97例成年患者中，OCR的绝对风险（13 - 20%）和PONV（24小时后为21 - 31%）较低，组间无差异。与硫喷妥钠-异氟烷相比，使用丙泊酚（无论是否使用氧化亚氮）预防PONV的需治疗人数为7至11。与硫喷妥钠-异氟烷相比，丙泊酚导致一次OCR的需伤害人数为17。
接受斜视手术并预防性使用阿托品的成年患者，OCR和PONV风险较低，与所采用的麻醉技术无关。
