不同麻醉方法在神经外科麻醉中的临床效果观察.pdf

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1、·i仑善·JMedRes．Oct2013．Vo1．42No．10不同麻醉方法在神经外科麻醉中的临床效果观察王海燕邹亮孙莉摘要目的瑞芬太尼复合异丙酚或七氟醚全凭静脉麻醉或静吸复合麻醉用于颅脑手术麻醉效果的临床观察。方法选择45例择期行开颅手术的患者，随机分为A组(瑞芬太尼复合异丙酚组)，B组(瑞芬太尼复合七氟醚组)和c组(瑞芬太尼复合异丙酚和七氟醚组)，每组15例。观察比较3组患者术中不同时点平均动脉压(MAP)、心率(HR)、BIS等参数值；观察3组患者的苏醒时间、拔管时间、随意运动恢复时间、定向力恢复时间；观察记录麻醉恢复期是否有恶心呕吐发生。结果A组瑞芬太尼复合异丙酚全凭静脉麻醉对血流动

2、力学抑制明显，但能很好地抑制手术应激反应；B组(瑞芬太尼复合七氟醚组)和c组(瑞芬太尼复合异丙酚和七氟醚组)术中循环相对平稳。A组苏醒时间、拔管时间、随意运动恢复时间、定向力恢复时间明显长于B组和c组(P<0．05)。3组术后恶心呕吐不良反应发生率差异无统计学意义。结论3种麻醉方法均适用于神经外科手术麻醉。关键词脑电双频谱指数七氟醚异丙酚瑞芬太尼神经外科麻醉ObservationonTheClinicalEffectofDifferentAnesthesiaMethodsDuringNeurosurgeryAnesthesia．WangHaiyan，ZouLiang，SunLi．Depart

3、mentofAnesthesia，CancerHospital，ChineseAcademyofMedicalSciense，Beijing100021，ChinaAbstractObjectiveToobservetheclinicalefectofremifentanilcompoundpropofolorsevofluranetotalintravenousanesthesiaorintravenousinhalationalanesthesiausedinneurosurgeryanesthesia．MethodsForty—fivepatientsundergoingelectiv

4、eintracranialsur—gerywererandomlydividedintothreegroups：groupA(remifentanilcompoundpropofolgroup)，groupB(remifentanilcompoundsevoflu—ranegroup)andgroupC(renfifentanilcompoundpropofolandsevofluranegroup)with15casesineachgroup．TheMAP，HR，BISatdiferenttimepointduringtheoperationofthreegroupsofpatientsw

5、ereobservedandcompared．Theanalepsiatime，extubationtime，vol—untarymovementrecoverytimeandorientationrecoverytimewererecorded．Nauseaandvomitingintheanesthesiarecoveryperiodwereobservedandrecorded．ResultsTheremifentanilcompoundpropofolgroup(groupA)inhibitedobviouslyhemodynamics，butcouldwellrestrainsur

6、gicalstressreaction．ThecirculationofgroupB(remifentanilcompoundsevofluranegroup)andgroupeC(remifentanilCOB—poundpropofolandsevofluranegroup)wererelativelystableduringtheopertation．Theanalepsiatime，extubationtime，voluntarymove—mentrecoverytimeandorientationrecoverytimeofgroupAshowedsignificantlylong

7、erthangroupBandgroupC(P<0．05)．Therewasnosignificantdifferenceinpostoperativenauseaandvomitingamongthreegroups．ConclusionThreeanesthesiamethodsareapplicableinneurosurgeryanesthesia．KeywordsBispectralindex；Se