神经阻滞复合静脉全麻在颅脑手术中的应用

Application of nerve block combined with intravenous anesthesia in brain surgery

目的探讨神经阻滞复合静脉全麻在颅脑手术中应用的可行性与安全性。方法选择40例行额、颞、顶部开颅手术患者，随机分为全麻对照组（A组）和神经阻滞复合静脉全麻组（B组），两组均为20例。记录麻醉前、切皮、锯颅骨、打开硬膜30min和术毕缝皮时的平均动脉压（MAP），心率（HR）及清醒拔管时间。结果两组患者一般情况比较差异无统计学意义（P〉0．05），B组患者切皮锯颅骨及术毕缝皮各时点MAP和HR均低于A组（P〈0．05），拔管时间B组短于A组。结论神经阻滞复合静脉全麻可明显减轻血流动力学波动，缩短拔管时间，可安全应用于颅脑手术。

Objective To investigate the feasibility and safety of nerve block combined with intravenous anesthesia in brain surgery. Methods Forty routine frontal temporal, at the top of craniotomy patients with general anesthesia were randomly divided into control group （group A ） and nerve block combined with full- anesthetic group （group B）, there were 20 cases in each group. Recorded MAP, HR and awake extubation time before anesthesia, skin incision, saw the skull, open the dura mater and surgical treatment of 30 min and the completion of sewing leather. Results There was no significant difference between the two groups in general conditions. （ P 〉 0.05 ）. Group B patients with skin incision, saw the skull and the skin suture surgery completed MAP and HR at each time point were lower than that in group A （P 〈 0.05）. Extubation time of group B was shorter than that in group A. Conclusions Nerve block combined with intravenous anesthesia can significantly reduce the hemodynamic fluctuations, make extubation time shorter, can be used in brain surgery with security.