丙泊酚维持神经外科手术麻醉的三种方法比较

A comparative trial of three anesthetic techniques about propofol for craniotomy

目的 :比较颅内手术时以丙泊酚维持麻醉的 3种方法间是否存在重要临床差异。 方法 :45例患者随机分为 3组 ,均先用丙泊酚 (2 m g/ kg) ,芬太尼 (2 μg/ kg)和阿曲库铵 (0 .5 m g/ kg)诱导 ;维持麻醉时 : 组 (n=13)单用丙泊酚 , 组 (n=16 )丙泊酚复合 0 .7%异氟烷 , 组 (n=16 )丙泊酚复合芬太尼 (分别在切皮、切硬脑膜、缝皮时追加 )。 3组丙泊酚给药速度均根据血压变化调整。 结果 : 组丙泊酚平均用量为 (9.5 9± 1.2 0 ) mg/ (kg· h) ,显著高于 组 [(6 .13± 0 .80 ) mg/ (kg· h) ]和 组[(5 .94± 0 .2 5 ) mg/ (kg· h) ](P<0 .0 5 )。 组切皮时血压上升发生率最低 (7% )。脑张力评分和苏醒情况以 组最好。结论 :丙泊酚复合芬太尼维持神经外科手术优于单纯丙泊酚或丙泊酚复合异氟烷。

Objective: To compare 3 anesthetic techniques of propofol for elective craniotomy to determine whether there is important clinical differences. Methods: Forty five patients were assigned into 3 groups. Anesthesia were induced with propofol (2 mg/kg), fentanyl (2 μg/kg) and atracurium (0.5 mg/kg), and maintained with propofol alone in group Ⅰ ( n =13), propofol and isoflurane in group Ⅱ ( n =16), propofol supplemented with fentanyl in group Ⅲ ( n =16). The rates of propofol in 3 groups were varied with blood pressure. Results: The mean rate of propofol in group Ⅰ was signifi cantly higher than other 2 groups ( P <0.05). The morbility of increased blood pressure during incision in group Ⅲ was lower than other groups. Conclusion: According to brain swelling score and recovery time in the group Ⅲ, this study suggests that propofol supplemented with fentanyl is advantageous over other groups. [