快通道麻醉在颅内动脉瘤栓塞术的应用  

The application of the fast-track anaesthesia in intracranial aneurysm

作　　者：詹玉茹[1] 张文华[1] 张君婷[1] 魏雪莲[1] 

机构地区：[1]齐齐哈尔医学院附属第三医院,161000

出　　处：《中国实用医药》2010年第25期22-23,共2页China Practical Medicine

摘　　要：目的对比研究喉罩通气和气管插管复合瑞芬太尼、丙泊酚全凭静脉麻醉在颅内动脉瘤栓塞术的应用。方法 48例经DSA行颅内动脉瘤栓塞术的患者随机分为喉罩组(L组)和气管插管组(T组),术中以微量泵持续泵注丙泊酚、瑞芬太尼维持麻醉,记录在麻醉诱导前、插入喉罩或气管插管时、插入后、动脉瘤栓塞及拔除喉罩或气管插管时、拔除后5min的平均动脉压(MAP)、心率(HR)、血氧饱和度(SPO2)、气道峰压(Pmax)、气道平均压(Pmean)、呼气末二氧化碳分压(PETCO2)的变化,观察术毕患者自主呼吸恢复时间、睁眼时间、拔管时间以及拔除时患者是否呛咳、躁动、恶心呕吐。结果喉罩组(L组)麻醉诱导、术中维持及术后苏醒血液动力学平稳,苏醒迅速,并发症发生率低。结论喉罩复合瑞芬太尼丙泊酚全凭静脉麻醉应用于颅内动脉瘤栓塞术安全、可行。Objective To compare the use of laryngeal mask with endotracheal intubation combination remifentaniland propofol in intracranial aneurysm. Methods Fourty-eight patients scheduled for intracranial aneurysm were divided randomlyinto two groups. The patients were inserted laryngeal mask or intubation after intravenous induction and received infusion propofol and remifentanil. Hemodynamic paraments were continuously monitored. The time of recovery breath,extradule,awaken were recorded. Whether coughing,restlessness and nausea and vomiting when extradule intubation were also recorded. Results The patients that insert laryngeal combination propofol with remifentanil were stable during induction,operation and recovery. Hemodynamic parameters were more stable,awake were more rapid. Conclusion Laryngeal mask with propofol andremifentanil is more suitable for intracranial aneurysm.

关 键 词：喉罩 瑞芬太尼 丙泊酚 颅内动脉瘤栓塞术 快通道麻醉 

分 类 号：R614[医药卫生—麻醉学]