全凭静脉麻醉与静吸复合麻醉在颅内动脉瘤夹闭术中的效果比较  

Comparison of effects of total intravenous anesthesia and combined intravenous and inhalation anesthesia in intracranial aneurysm clipping

作　　者：曾祥鑫 刘宇权 廖亿粦[1] ZENG Xiangxin;LIU Yuquan;LIAO Yilin(No.1 Department of Anesthesiology Meizhou People's Hospital,Meizhou 514031,China)

机构地区：[1]梅州市人民医院麻醉一科

出　　处：《中华灾害救援医学》2020年第2期71-73,共3页Chinese Journal of Disaster Medicine

摘　　要：目的探讨全凭静脉麻醉与静吸复合麻醉在颅内动脉瘤夹闭术中的应用效果。方法选取梅州市人民医院拟行颅内动脉瘤夹闭术的患者60例,根据麻醉方法不同分为观察组(n=30)和对照组(n=30)。两组均采用静脉麻醉诱导,在此基础上,对照组采用吸入七氟醚、静脉输注瑞芬太尼维持麻醉;观察组采用静脉输注丙泊酚、瑞芬太尼维持麻醉,对比两组术中血流动力学及不良反应情况。结果麻醉诱导前、麻醉诱导后,两组收缩压、舒张压及心率比较,差异无统计学意义(P>0.05);观察组气管插管后、开颅时、手术结束时收缩压、舒张压、心率均低于对照组,差异有统计学意义(P<0.05);观察组麻醉期间不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论颅内动脉瘤夹闭术中实施全凭静脉麻醉,血压及心率比静吸复合麻醉稳定,能减少麻醉期间不良反应。Objective To explore application effects of total intravenous anesthesia and combined intravenous and inhalation anesthesia in intracranial aneurysm clipping. Methods 60 cases undergoing the intracranial aneurysm clipping in Meizhou people’s hospital were selected, and divided into observation group and control group according to the random number table method, 30 cases in each group. The two groups were induced by intravenous anesthesia. Besides, the control group was maintained by anesthesia with sevoflurane inhalation and remifentanil infusion, while the observation group was maintained by the intravenous infusion of propofol and remifentanil. Then, the intraoperative hemodynamics and adverse reactions were compared between the two groups. Results There were no significant differences in the systolic blood pressure, diastolic blood pressure and heart rate between the two groups before and after anesthesia induction(P>0.05). The systolic blood pressure, diastolic blood pressure, and heart rate of the observation group after tracheal intubation, during craniotomy, and at the end of surgery were lower than those of the control group, and the differences were statistically significant(P<0.05). The incidence of adverse reactions during the anesthesia in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusions Compared with combined intravenous and inhalation anesthesia, the application of total intravenous anesthesia during the intracranial aneurysm clipping can stabilize the blood pressure and heart rate and reduce the adverse reactions during anesthesia.

关 键 词：颅内动脉瘤夹闭术 全凭静脉麻醉 静吸复合麻醉 丙泊酚 七氟醚 

分 类 号：R614.2[医药卫生—麻醉学]