脑血管疾病血管内治疗的麻醉管理与监测

Management and Monitoring of Anesthesia for Endovascular Treatment in Patients with Cerebrovascular Disease

目的 探讨脑血管疾病微导管血管内介入治疗的麻醉管理与监测。方法 22例脑血管疾病患者手术开始前先用咪唑安定0.06mg/kg缓慢滴入,静注异丙酚1mg/kg镇静,随后接静脉输注泵,以25～75μg/kg/min持续输注,同时以1～3μg/kg/min持续输入硝普钠控制性降压。结果 22例患者均安全度过手术。栓塞时血压明显较术前低,术中心率、血氧饱和度较术前无明显变化。适度镇静百分比为86％(19/22),完全遗忘百分比73％(16/22)。3例病人出现术后恶心呕吐。结论 有监测的麻醉管理用于脑血管疾病微导管血管内介入治疗安全有效。

Objective To explore management and Monitoring of Anesthesia for endovascular treatment in the patients with cerebrovascular disease. Methods Twenty-two patients with cerebrovascular disease received intravenously bolus midazolam 0.06 mg/ kg and propofol 1mg/kg before the operation, and then continuous intravenous infusion of propofol 25-75 μg/kg/min. Controlled hypotension was induced by continuous intravenous infusion of sodium nitroprusside 1-3μg/kg/min when the operation was performed. Results The blood pressure was lower during the operation than before the operation in the patients with cerebrovascular disease. There was no significant change in heart rate and saturation of blood oxygen during the operation. Percentage of the patinent with adequate sedation was 86% (19/22) and total amnesia was 73% (16/22). Three patients had nausea and vomit after the operation. Conclusion The monitored anesthesia care is suitable for the endovascular treatment in the patients with cerebrovascular disease.