舒芬太尼与瑞芬太尼复合异丙酚在脑功能区手术唤醒麻醉中的应用

Use of continuous infusion of sufentanil and remifentanil combined propofol for awake craniotomy

目的探讨持续输注丙泊酚和瑞芬太尼复合舒芬太尼在脑功能区手术唤醒麻醉中的应用。方法 8例患者用丙泊酚和瑞芬太尼持续输注复合舒芬太尼静脉给药,术前1d均用焦虑自评量表(Self-Rating AnxietyScale,SAS)评出手术患者的主观感受。术中行神经电生理监测,按脑功能区定位时态的评判标准对其进行评估。结果 8例唤醒麻醉手术过程顺利,语言清晰者7/8,指令准确7/8,无痛8/8,颅内压正常7/8,脑组织轻度膨胀1/8。优7/8,良1/8,差0/8。结论丙泊酚和瑞芬太尼持续输注复合舒芬太尼应用于脑功能区手术唤醒麻醉是较好的麻醉方法。

Objective To explore the use of continuous infusion of propofol,remifentanil and sufentanil for awake craniotomy.Methods 8 patients were anesthetized with continuous infusion of propofol and remifentanil and sufentanil intravenous injection.The subjective attitudes of the patients were evaluated by the Self-Rating Anxiety Scale（SAS） at the day before the operations.The SEP was used to monitor the patients during the operations.The awaking degree was assessed according to the standard of eloquent brain areas mapping status.Results Eloquent brain areas surgery was achieved in 8 patients and no pain.7 patients＇ sound of voice was clear and the ability of orientation was accuracy in 8 patients.7 patients＇ intracranial pressure was normal.Slight brain swelling was found in one patient.7 cases were excellent and 1 case was good.Conclusion Continuous infusion of propofol,remifentanil and sufentanil for awake craniotomy is a good anesthesia technique.It has significant value in eloquent brain area surgery.