喉罩及靶控输注应用于神经外科术中唤醒麻醉  

Awaking Anaesthesia by LMA and TCI in Neurosurgery Operation

作　　者：孟春[1] 梁禹[1] 李恒林[1] 

机构地区：[1]天津市环湖医院麻醉科,天津300060

出　　处：《白求恩军医学院学报》2006年第2期78-79,共2页Journal of Bethune Military Medical College

摘　　要：目的应用神经外科术中唤醒麻醉方法配合手术医师精确定位并切除脑功能区占位性病变,减少神经功能障碍并发症的发生,提高患者生存质量。方法对5例脑功能区占位病变患者进行喉罩插管、异丙酚靶控输注和雷米芬太尼镇痛,行术中唤醒,在清醒状态下通过皮质诱发电位监测及电刺激进行脑功能区定位和病灶切除,然后再次实施全麻进行关颅。结果5例患者均顺利经过喉罩插管下全麻、术中唤醒、再全麻的过程,呼吸和循环指标平稳,镇痛完善,完全配合术者要求进行脑功能区定位及病灶切除,无术后神经功能障碍发生,2例在唤醒期间出现轻微血压升高和心率加快,1例出现术后痛苦回忆。结论全麻唤醒技术的应用有助于最大程度地切除脑功能区病灶并尽量保持正常脑功能,提高患者术后生存质量。Objective To study the method of awaking anaesthesia by laryngeal mask airway（LMA） and target controlled infusion（TCI）to map the lesions in the cerebral eloquent areas exacdy during neurosurgery operation. Methods 5 patients with lesions in the cerbral eloquent areas were undergone LMA intubation, propofol TCI and remifentanil analgesia, awaked during operatien to do functional mapping and resect lesions, then anaesthesiaed again until the operation end. Results All patients were undergone anaesthesia, awaked, re-anaesthesia successfully, vital signs were good,the lesions were mapped precisely and then were resected. There was no neural function deterioration after operation. Only 1 patient had bad memory during operation. Conclusion Awaking anaesthesia by LMA and TCI in neurosurgery operation is a goed and safe method which can not only resect lesions maximumly but also protect the normal neural function.

关 键 词：喉罩 靶控输注 术中唤醒 

分 类 号：R642.1[医药卫生—外科学]