SPR手术治疗小儿脑瘫的麻醉探讨  

The Discussion on Anesthesia of Spinal Posterior Poot Amputation to Treat Cerebral Paralysis in Child

作　　者：赵小冬[1] 关兴昌[1] 路道远[1] 耿凤芝 原春雷[1] 柳永滨 管德辉 陈大雷[2] 

机构地区：[1]武警黑龙江省总队医院 [2]武警脑瘫医学专科中心

出　　处：《黑龙江医学》1999年第5期3-4,共2页Heilongjiang Medical Journal

摘　　要：高选择性脊神经后根切断术即SPR手术，是目前治疗痉挛型脑瘫的有效方法之一，如何麻醉才能满足手术的要求。本文总结了我院530例脑瘫痉挛型患儿的麻醉，以探讨麻醉方法的选择及术中管理问题，采用的方法是快速诱导插管后，给予1％普鲁卡因和七氟醚吸入维持，着重视察插管前后和俯卧位前后的HR、NIBP、SaO2等，同时用TOFGuard加速度仪测定拇指内收肌的收缩反应，以判断麻醉深度。笔者认为插管前后及置俯卧位前后循环的变化显著，须给予对症处理，得出静注阿曲库铵0．5mg／kg或琥珀酰胆碱1．0mg／kg所达到的肌松程度，可以很好的满足SPR测试的要求，认为依托咪酯、芬太尼、卡肌宁的配伍使用对循环的影响很小，得出结论是静吸复合麻醉可以满足脑瘫SPR手术的要求。The anesthesia of 530 cases cerebral paralysis children in spasm thpe was analyzed to discuss the selection of anesthetic method and management. After rapid inducing intracubation and maintaining with 1 % procaine and sevoflurane,the HR, NIBP and SaO2 were observed pre and post intracubation and prone position while examine the contraction of adductor muscle of thumb to assess the depth of anesthesia. There were great changes between pre and post results. So the intravenous combined anesthesia could be available to SPR hecause the atracurium combined with scoline and etomibate had less affection to circulation system.

关 键 词：静吸复合麻醉 SPR 手术治疗 小儿脑瘫 插管 治疗 收缩反应 加速度仪 要求 结论 

分 类 号：R614[医药卫生—麻醉学] R742.3[医药卫生—外科学]