两种不同麻醉方法用于颅内动脉瘤介入术的临床观察(1)
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【摘要】目的通过比较两种不同的麻醉方法用于颅内动脉瘤介入术,探求颅内动脉瘤介入术最佳的麻醉方法。方法选择ASAⅠ~Ⅲ级颅内动脉瘤介入术患者40例,随机分为两组,每组各20例,两组麻醉诱导相同,气管插管后,Ⅰ组持续输注瑞芬太尼0.2~0.4 μg/(kg·min),异丙酚4~6 mg/(kg·h)维持;Ⅱ组吸入2.0%~2.5%七氟醚维持麻醉,术中根据临床征象如血压、心率、ETCO2、体动等,随时调整输注速度及吸入麻醉药的浓度,必要时间断加入罗库溴胺10 mg,记录术毕至清醒时间及术毕至拔管时间,观察患者苏醒期躁动情况,随访术后恶心、呕吐和术中知晓。结果清醒时间Ⅰ组为(6.9±2.1)min,Ⅱ组(9.8±3.0 min)(P<0.05),拔管时间Ⅰ组为(9.0±2.7)min,Ⅱ组为(12.6±3.8)min(P<0.05),苏醒期躁动发生率Ⅰ组为0,Ⅱ组为30%(6/20),术后恶心、呕吐发生率差异无统计学意义,两组均无术中知晓。结论瑞芬太尼复合异丙酚持续输注用于颅内动脉瘤介入术优于七氟醚吸入麻醉。
【关键词】
麻醉方法;颅内动脉瘤;介入术
Two different methods of anesthesia for interventional treatment of intracranial aneurysms Clinical Observation
ZHANG Huidong,YU Mingtao,ZHANG Yun.Department of Anesthesiology,Weihai Municipal Hospital,Weihai 264200,China
【Abstract】ObjectiveTo compare two different methods of anesthesia for intracranial aneurysm surgery inervention,To explore the best methods of anesthesia.MethodsForty patients of ASA Ⅰ~Ⅱ grade intracranial aneurysm surgery,were randomly divided into two groups,each of twenty cases,the same two sets of induction of anesthesia,after intubation,group Ⅰremifentanil infusion 0.2~0.4 ug/kg/min,propofol 4~6 mg/kg/h maintained,Grou p Ⅱof 2.0%~2.5% inhaled sevoflurane to maintain anesthesia,surgery based on clinical signs such as blood pressure,heart rate,ETCO2,and other physical activities,at any time adjust the infusion rate and the concentration of inhaled anesthetics,When necessary ,Additional Rocuronium 10 mg,Records of patients with surgery to clear the end of time and the end of surgery to extubation time.Awake period of observation of the situation in patients with restless,the followup of postoperative and intraoperative known.ResultsSober timegroup Ⅰ(6.9±2.1)min,group Ⅱ(9.8±3.0)min,(P<0.05),extubation time group Ⅰ(9.0±2.7)min,group Ⅱ(12±3.8)min(P<0.05),the incidence of restless awake period group Ⅰ 0,group Ⅱof 30%(6/20),Postoperative nausea and vomiting incidence was no significant difference in the two groups had no knowledge of surgery.ConclusionRemifentanil combined with propofol infusion for intracranial aneurysm surgery intervention is superior to sevoflurane inhalation anesthesia ......
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