七氟烷对经皮穿刺微球囊压迫术治疗老年原发性三叉神经痛患者三叉神经心脏反射的影响  

Effect of sevoflurane on trigeminal-cardiac reflex in elderly patients with primary trigeminal neuropathy treated by percutaneous balloon compression

作　　者：聂超然 李京生[1] 高鑫 王天龙[1] Nie Chaoran;Li Jingsheng;Gao Xin;Wang Tianlong(Department of Anesthesiology and Operating Theater,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院麻醉科,北京100053

出　　处：《北京医学》2022年第3期253-256,共4页Beijing Medical Journal

基　　金：北京市属医学科研院所公益发展改革试点项目(京医研2019-2)。

摘　　要：目的比较七氟烷与丙泊酚对老年原发性三叉神经痛(primary trigeminal neuralgia,PTN)患者在行经皮穿刺微球囊压迫术(percutaneous balloon compression,PBC)治疗时三叉神经心脏反射(trigemino-cardiac reflex,TCR)的影响。方法选取2019年1月至2021年8月首都医科大学宣武医院行PBC治疗的老年PTN患者120例,其中使用七氟烷复合瑞芬太尼麻醉60例(S组),丙泊酚复合瑞芬太尼麻醉60例(P组)。比较两组穿刺至卵圆孔(T_(1))和球囊充盈压迫(T_(2))时发生TCR的情况,发生TCR时HR和平均动脉压(mean arterial pressure,MAP)的下降比及阿托品治疗情况。结果T_(1)时,S组发生TCR时MAP及HR下降比低于P组[(27.0±4.1)%比(30.0±5.1)%,(27.7±4.7)%比(30.6±5.4)%],差异均有统计学意义(P<0.05);发生TCR时,P组有11例(28.2%)、S组有7例(21.9%)需使用阿托品治疗,两组比较差异无统计学意义(P>0.05)。T_(2)时,S组发生TCR时MAP及HR下降比与P组比较,差异无统计学意义(P>0.05);发生TCR时,P组有17例(48.6%)、S组有8例(20.5%)需使用阿托品治疗,两组比较差异有统计学意义(P<0.05)。结论七氟烷并不能减少TCR的发生率,但可以减轻发生TCR时的循环波动,并减少发生TCR后阿托品的使用率。Objective To compare the effect of sevoflurane and propofol on trigemino-cardiac reflex(TCR)in elderly patients with primary trigeminal neuralgia(PTN)during percutaneous balloon compression(PBC).Methods A total of 120 elderly patients with PTN who received PBC treatment in Xuanwu Hospital,Capital Medical University from January 2019 to August 2021 were selected,including 60 cases of sevoflurane combined with remifentanil anesthesia(group S),and 60 cases of propofol combined with remifentanil anesthesia(group P).The occurrence of TCR when puncture to foramen ovale(T_(1))and balloon filling compression(T_(2)),the decline ratio of HR and mean arterial pressure(MAP)and atropine treatment were compared between the two groups.Results At T_(1),the decrease ratio of MAP and HR when TCR occurred in group S was lower than those in group P[(27.0±4.1)%vs.(30.0±5.1)%,(27.7±4.7)%vs.(30.6±5.4)%],the differences were statistically significant(P<0.05).When TCR occurred,11 cases(28.2%)in group P and seven cases(21.9%)in group S needed atropine treatment,there was no significant difference between the two groups(P>0.05).At T_(2),there was no significant difference in the decrease ratio of MAP and HR when TCR occurred in group S and group P(P>0.05).When TCR occurred,17 cases(48.6%)in group P and eight cases(20.5%)in group S needed atropine treatment,the difference between the two groups was statistically significant(P<0.05).Conclusions Sevoflurane can not reduce the incidence of TCR,but can reduce the cyclic fluctuation during TCR and the use of atropine after TCR.

关 键 词：经皮穿刺微球囊压迫术 三叉神经心脏反射 七氟烷 原发性三叉神经痛 老年 

分 类 号：R614[医药卫生—麻醉学]