颈动脉内膜剥脱术三重麻醉法临床研究与应用

Clinical Research and Application in Carotid Endarterectomy under Triple Anesthesia Method

目的:探讨颈动脉内膜剥脱术(CEA)的三重麻醉方法的效果。方法:对58例颈动脉重度狭窄的患者实施CEA采用全麻、颈丛神经阻滞和颈动脉窦浸润复合三重麻醉的方法。在病变侧行颈丛神经阻滞,全麻诱导,安氟醚吸入麻醉,术中局麻药浸润颈动脉窦,间断注射芬太尼和维库溴铵维持麻醉。结果:颈动脉阻断时间平均为(28.3±3.5)min,术后1例出现谵妄,5例出现高血压,对症处理后,均康复出院。结论:全麻、颈丛神经阻滞和颈动脉窦浸润复合三重麻醉方法应用于CEA是比较安全的麻醉方法,术中血流动力学和生命体征均平稳。

To investigate the effect of carotid endarterectomy under triple anesthesia method. Method： 58 cases of severe carotid stenosis patients undergoing carotid endarterectomy were under general anesthesia and cervical plexus block combined with Carotid sinus infiltration anesthesia;Cervical plexus block in the side of the lesion line, Induction of general anesthesia, Enfiurane inhalation anesthesia, during the operation , anesthetic infiltration of the carotid sinus, Anesthe- sia was maintained with intermittent injections of Fentanyl and Vecuronium. Result： The blocking time of carotid in average is （28.3 -＋ 3.5） min, after operation, one case appears delirium, 5 cases appear hypertension, after symptomatic treatment, they were all recovered and discharged. Conclusion： The triple anesthesia method, general anesthesia and cervical plexus block and carotid sinus infiltration used in CEA, is a relatively safe method of anesthesia. The intraoperative hemodynamic and vital signs were stable.