术中磁共振影像神经导航手术的麻醉管理  

Anesthetic management for intraoperative magnetic resonance image-guided neurosurgery

作　　者：张军[1] 丁晓楠[1] 汪乐天[1] 梁伟民[1] 

机构地区：[1]复旦大学附属华山医院麻醉科,上海市200040

出　　处：《临床麻醉学杂志》2008年第2期112-113,共2页Journal of Clinical Anesthesiology

摘　　要：目的探讨术中磁共振（iMR）影像神经导航辅助神经外科手术的麻醉管理。方法22例神经外科手术患者采用核磁兼容或核磁可用的麻醉材料和设备，在全身麻醉（静吸复合或全凭静脉麻醉）下行iMR影像神经导航辅助颅内肿瘤切除术，术中监测心率、有创血压、脉搏血氧饱和度、呼气末二氧化碳分压、七氟醚浓度、中心静脉压以及动脉血气。结果22例患者肿瘤的全切率从60．0％提高到86．4％。术中患者iMR扫描次数2～5次，手术时间延长1～3h，术中未发生与麻醉和iMR相关的并发症和意外事件。结论在iMR影像神经导航下行颅内肿瘤切除术的围术期麻醉处理中关注iMR影像神经导航外科相关的信息、手术室应用环境、麻醉技术和药物的选择以及围术期管理对患者的安全是重要的。Objective To investigate the anesthetic management for intraoperative magnetic resonance （iMR） image-guided neurosurgery. Methods Twenty-two neurosurgical patients received intracranial tumor resection via iMR image-guided system under genernal anesthesia in operation room. HR, SpO2, IBP, CVP,PETCO2 and blood gas analysis were monitored intraoperatively. Results Total tumor resection rate increased from 60.0% to 86.4% with iMR image-guided system. The operation time was prolonged for 1 to 3 hours resulting from 2 to 5 times iMR scan in each patient. No anesthesia or iMR-related complications and accidental events occurred intraoperatively in 22 cases. Conclusion Focusing on iMR-related procedure,operative enviroment,choice of anesthetic techniques and regimens as well as vigilant care are all important for the patients undergoing iMR image-guided neurosurgery.

关 键 词：磁共振 神经导航 麻醉管理 围术期 

分 类 号：R614[医药卫生—麻醉学]