Matsumoto H, Shingu K, Numata K, Ogura S, Hanaoka K, Ito H, Kugimiya T, Kazama T, Ikeda K, Murakawa M, Mori K, Mashimo T, Yoshiya I, Morio M, Nakao M, Sato A
Department of Anesthesiology, Kansai Medical University, Moriguchi.
Masui. 1998 Sep;47(9):1046-58.
A randomized, prospective and multi-institutional study was performed to investigate whether different anesthetic methods affected differently the quality of recovery from anesthesia. Two hundred and eleven patients were allocated to one of two groups; total intravenous anesthesia (TIVA) with propofol and fentanyl (group P, n = 107) and general anesthesia with thiopental, sevoflurane and nitrous oxide (group TS, n = 104). The rapidity of emergence from anesthesia and postoperative incidence of nausea, vomiting, and headache were compared between the two groups. The group P showed significantly shorter emergence times for verbal command responses (7.4 +/- 5.6 min), extubation (10.0 +/- 6.0 min) and orientation (13.1 +/- 7.8 min) than the group TS (9.1 +/- 5.0 min, 11.7 +/- 6.2 min, 16.4 +/- 7.9 min, respectively). The postoperative incidence of vomiting was not significantly different between the two groups (3.7% in the group P and 9.6% in the group TS), but the postoperative incidences of nausea and headache were significantly lower in the group P compared with the group TS (10.3%, 17.8%, respectively in the group P and 34.6%, 29.8%, respectively in the group TS). We conclude that TIVA with propofol is advantageous than thiopental-sevoflurane anesthesia in the recovery phase.
进行了一项随机、前瞻性、多机构研究，以调查不同麻醉方法对麻醉恢复质量的影响是否不同。211例患者被分配到两组中的一组；丙泊酚和芬太尼全静脉麻醉（P组，n = 107）以及硫喷妥钠、七氟醚和氧化亚氮全身麻醉（TS组，n = 104）。比较了两组患者麻醉苏醒的速度以及术后恶心、呕吐和头痛的发生率。P组患者对语言指令反应的苏醒时间（7.4±5.6分钟）、拔管时间（10.0±6.0分钟）和定向时间（13.1±7.8分钟）显著短于TS组（分别为9.1±5.0分钟、11.7±6.2分钟、16.4±7.9分钟）。两组术后呕吐发生率无显著差异（P组为3.7%，TS组为9.6%），但P组术后恶心和头痛发生率显著低于TS组（P组分别为10.3%、17.8%，TS组分别为34.6%、29.8%）。我们得出结论，在恢复阶段，丙泊酚全静脉麻醉比硫喷妥钠-七氟醚麻醉更具优势。
