单次肌松药全身麻醉下进行神经外科手术的可行性  

The feasibility of neurosurgery under general anesthesia with a single dose of muscle relaxant

作　　者：李玉兰[1] 刘映龙[1] 徐成明[1] 吕兴华[1] 万占海[1] 

机构地区：[1]兰州大学第一医院麻醉科,甘肃兰州730000

出　　处：《中国医药导报》2012年第6期80-81,83,共3页China Medical Herald

基　　金：甘肃省科技厅技术研究与开发专项(项目编号:0912TCYA015)

摘　　要：目的探究单次肌松药全身麻醉下进行神经外科手术的可行性。方法选取我院ASAⅠ～Ⅱ级全身麻醉下进行神经外科手术患者60例,随机分为阿曲库铵组(A组)和琥珀酰胆碱组(S组),每组各30例。麻醉诱导后停用肌松药,全程仅用得普利麻、瑞芬太尼静脉泵注维持电脑双频指数(BIS)麻醉。观察两组麻醉药用量、肌松恢复时间、术中体动次数、气道压、拔管时间、残余肌松发生率、拔管时间及外科麻醉评分。结果两组患者均无术中体动,S组2例发生呛咳;A组肌松恢复时间较S组长(P<0.01)。两组其他手术条件、麻醉药用量比较差异无统计学意义(P>0.05)。结论单次肌松药全身麻醉下进行神经外科手术是基本可行的,但在这种麻醉状态下不宜进行气管内操作。Objective To evaluate the feasibility of neurosurgery under general anesthesia with single dose of muscle relaxant.Methods 60 patients with ASA Ⅰ-Ⅱ scheduled for neurosurgery were randomly divided into Atracurium（group A） and Succinylcholine（group S）,each group had 30 cases.After anesthesia induction and intubation with a single use of Atracurium or Succinylcholine,anesthesia was maintained with Propofol and Remifentanil at BIS level.The duration of neuromuscular blocking,the anesthetics consumption,the presence of unwanted patient movement,the airway pressure,the extubation delay and the rate of residual neuromuscular blockade of two groups were recorded.The surgical conditions were scaled by surgeons after operation.Results No patients＇ movement was observed during operation,there were 2 patients of control group had cough.The recovery time of muscle tone in group A was longer than group S（P 〈0.01）.The anesthetics consumption and the airway pressure were similar between two groups（P 〉0.05）.Conclusion The feasibility of neurosurgery under general anesthesia with a single dose of muscle relaxant is affirmed,but airway stimulation is not allowed in this condition.

关 键 词：神经外科手术 神经肌肉阻滞药 全身麻醉 

分 类 号：R614[医药卫生—麻醉学]