丙泊酚全凭静脉麻醉对玻璃体切除术后当天患者恢复质量的影响：随机对照试验
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Patient quality of recovery on the day of surgery af ter propof ol total intravenous anesthesia f or vitrectomy：A randomized controlled trial
背景与目的
全身麻醉是⻔诊玻璃体切除术可选的麻醉⽅法。为了⻔诊⼿术的成功，应选择具有术后恢复质量好的麻醉⽅法。为此我们通过采⽤质量恢复（QoR）-40问卷对玻璃体切除术后患者的恢复质量进⾏评估，从⽽对丙泊酚全凭静脉麻醉（丙泊酚组）和地氟醚吸⼊麻醉（地氟醚组）两种代表性的麻醉⽅法进⾏⽐较。
方 法
将全麻下择期⾏玻璃体切除术的84名患者（20-80岁）随机分为2组。丙泊酚组使⽤效应室浓度靶控输注（T CI）丙泊酚和瑞芬太尼，地氟醚组吸⼊地氟醚并使⽤效应室浓度靶控输注（T CI）瑞芬太尼。通过使⽤QoR-40调查问卷评估患者术后6⼩时的恢复质量。并收集了患者苏醒期和恢复期间与其术后恢复和并发症相关的数据。
结 果
丙泊酚组术后当天QoR-40评分中位数显著⾼于地氟醚组（分别为181.0和169.5，P=.033）。特别是在身体舒适度和身体独⽴性⽅⾯得分显著更⾼。丙泊酚组瑞芬太尼需药量明显增加且苏醒时间明显延⻓。然⽽，两组之间的其他并发症没有显著差异。
结 论
与地氟醚吸⼊麻醉相⽐，丙泊酚全凭静脉麻醉在术后当天能使患者具有更好的恢复质量。
原始文献摘要
Na SH1, Jeong KH2, Eum D2, Park JH1, Kim MS1 Patient quality of recovery on the day of surgery af ter propof ol total intravenous anesthesia f or vitrectomy：A randomized controlled trial Medicine (Baltimore). 2018 Oct;97(40):e12699. doi: 10.1097/MD.0000000000012699.
Background: Vitrectomy under general anesthesia is considered as a candidatef or ambulatory surgery. An anesthetic method with high quality of postoperative recovery should be selected for successf ul ambulatory surgery. We thus compared quality of
postoperative recovery on the day of vitrectomy using the Quality of Recovery (QoR)-40 questionnaire between propof ol total intravenous anesthesia
(propof ol group) and desflurane inhalation anesthesia (desflurane group) as the 2 representative anesthetic methods.
Methods: Eighty-f our patients (20–80 years old) undergoing elective vitrectomy under general anesthesia were randomized into 2 groups. The propof ol group received propof ol and remif entanil using eff ect-site target-controlled inf usion (TCI), and the desflurane group received desflurane inhalation and remif entanil using eff ect-site TCI. We assessed quality of recovery at 6hours af ter surgery through interviews using the QoR-40 questionnaire. We also collected data related to recovery and complications during emergence and recovery period.
Results: The median of QoR-40 score on the day of surgery was significantly higher in the propof ol group than that in the desflurane group (181.0 vs 169.5, respectively; P=.033). In particular, propof ol group had significantly higher scores for physical comf ort and physical independence dimensions. The amount of remifentanil administered was significantly higher, and the emergence time was significantly longer in propofol group. However, there were no significant differences in other complications between the 2 groups.
Conclusions: Propof ol total intravenous anesthesia provided significantly better quality of recovery on the day of surgery than desflurane inhalation anesthesia.
麻醉学文献进展分享
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编辑：李华宇 审校：代东君