喉罩全麻用于立体定向深部脑电刺激手术的研究及其并发症处理  

Research on laryngeal mask anesthesia in stereotactic deep brain stimulator surgery and the treatment of complications

作　　者：查鹏[1] 田肇隆[1] 王小华[1] 王天龙[1] 

机构地区：[1]首都医科大学宣武医院麻醉科,北京100053

出　　处：《立体定向和功能性神经外科杂志》2014年第1期4-8,共5页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的将喉罩全麻用于功能神经外科立体定向手术，以适应手术的特殊需要，并减轻其血流动力学反应及其并发症。方法功能神经外科拟行脑深部电刺激手术帕金森病患者120例（其中男性71例，女性49例），ASA分级Ⅰ一Ⅱ级，年龄36-76岁，体重49-95kg。常规麻醉诱导后，给予喉罩全麻，进行立体定向脑深部电刺激手术。记录麻醉诱导前（基础值）、喉罩置人前、喉罩置入即刻及喉罩置入后1、2、3、5、10分钟时的血压、心率和脑电双频指数（bispectralindex，BIS）。观察患者喉罩置入的血流动力学变化及其并发症。结果所有应用喉罩麻醉的患者均顺利完成手术，喉罩一次插入成功率〉90％，且无明显严重并发症。结论在控制通气方面，喉罩和气管插管同样的安全、有效，避免了气管插管期间的血流动力学变化，在立体定向手术麻醉管理方面存在巨大优势。Objective To study the use of lar3mgeal mask anesthesia in stereotactic deep brain stimulator surgery of functional neurosurgery., for the special requirement of operation and prevention of he- modynamic response. Mettmds 120 ASA Ⅰ-Ⅱ functional surgery patients （71 male,49 female） of Pakinson＇ disease aged 36-76yrs weighing 49~95 kg scheduled for stereotactic deep brain stimulator surgery under general anesthesia with laryngeal mask anesthesia was involved. Laryngeal mask was inserted after induction of anesthesia,and then stereotactic deep brain stimulator surgery was accomplished. Noninvasive BP, HR and BIS were recorded at the time before induction, the time before and just the time of laryngeal mask insertion and at 1,2,3,5,10 rain after laryngeal mask insertion was completed. Observe the hemodynamic response and complications of the laryngeal mask insertion. Results All patients underwent stereotaetie operation successfully by laryngeal mask anesthesia,the one time successful rate of laryngeal mask intubation was a- bove 90%, without violent hemodynamic response and obvious complication. Conclusion Laryngeal mask anesthesia is as safe and effective as endotracheal intuhation anesthesia,without violent hemodynamic chan- ges of the latter,and have great advantage in the anesthesia of stereotactic operation.

关 键 词：喉罩 立体定向手术 深部脑电刺激手术 血流动力学反应 并发症 

分 类 号：R614[医药卫生—麻醉学]