三种麻醉方法对长时间显微神经外科手术麻醉苏醒期的影响

Three Anesthesia methods’effects on Recovery durations after long time microneurosurgical

目的探讨吸入麻醉、全静脉麻醉和静吸复合麻醉三种方法对长时间显微神经外科手术病人苏醒期的影响,以寻找较好的麻醉方法。方法ASAⅠ～Ⅱ级择期显微神经外科手术病人90例,年龄18～65岁,随机分成吸入麻醉组(A)、全静脉麻醉组(B)和静吸复合(先吸入后静脉)麻醉组(C),每组30例。观察记录术毕停药后病人自主呼吸恢复时间(T1)、呼之睁眼时间(T2)、拔管时间(T3)、定向力恢复时间(T4)、离开手术室时间(T5)、意识状态(OAAS)、疼痛评分(VRS)及恶心呕吐。结果(1)T1、T2、T3、T4、T5三组之间均有显著性差异,时间C<B<A,(2)意识状态C组好于B组和A组,(3)疼痛发生率C组高于B组和A组。恶心呕吐及寒战发生率无显著性差异。结论静吸复合(先吸入后静脉)麻醉方法在长时间显微神经外科手术麻醉中明显优于吸入麻醉和全静脉麻醉方法。

Objective To compare the recovery durations of inhalation anesthesia, Intravenous Anesthesia and combined anesthesia after long time microneurosurgical operations.Methods：90 case of ASA Ⅰ～Ⅱ neurosurgical operations were randomly divided into three groups by different Anesthesia methods, Group A： Inhalation Anesthesia, Group B： Intravenous Anesthesia, Group C： combined anesthesia of Inhalation and Intravenous. There were 30 patients in each group, and the patients aged from 1B 65 years. The recovery duration of spontaneous breathing（T1）, eye opening at request（T2）, tracheal extubation（T3）, orientation ability（T4）,operation leaving（TS）, OAAS score and VRS score were recorded immediately after the tenmination of the anesthesia.Results： （1）There were statistic difference between3 groups in T1, T2, T3, T4, TS. Time for： TA〈TB〈TC. （2） In OAAS, Group C is batter than Group A and Group B.（3） Pain occurred （VRS） more frequently in Group C than in Group A or Group B.Conclusion： In long time microneurosurgical operations. Combined anesthesia is better than Intravenous Anesthesia and Inhalation Anesthesia.