七氟醚在颅内动脉瘤夹闭术中控制性降压的应用

Application of sevoflurane controlled hypotension in intracranial aneurysmal surgery

目的研究颅内动脉瘤夹闭术中七氟醚对控制性降压的可行性。方法选取2014年1月~2015年2月择期行颅内动脉瘤夹闭术患者14例,ASAⅢ~Ⅳ级,将其随机分为硝普钠组（N组）和七氟醚组（S组）,于切开硬脑膜平稳生命体征后开始控制性降压40~50 min,监测患者在控制性降压不同时间点平均动脉压（MAP）、心率（HR）、血氧饱和度（Sp O2）、中心静脉压（CVP）、二氧化碳末压（PETCO2）的水平,记录控制性降压的起效时间和复压到90%基础血压所需的时间,观察复压30 min时有无反跳性高血压出现。结果两组患者术中行控制性降压的起效时间、控制性降压效果均达到满意的效果,S组回复到90%基础血压的时间较N组长且未出现反跳性高血压。结论七氟醚用于颅内动脉瘤夹闭术控制性降压能达到满意效果。

Objective To study the feasibility of sevoflurane controlled hypotension in intracranial aneurysmal surgery.Methods 14 patients who selected conducting intracranial aneurysmal surgery ASAⅢ-Ⅳ degree from January 2014 to February 2015 were selected.Patients were randomly divided into sodium nitroprusside group（group N）and sevoflurane group（group S）.Controlled hypotension was started after cut dura mater with stable vital signs and continued for 40-50 min.The level of MAP,HR,Sp O2,CVP and PETCO2 were monitored at different times of controlled hypotension.The onset time of controlled hypotension and the needed time that the blood pressure re-pressed to 90% of basic blood pressure were recorded.At the same,whether bounce high blood pressure appeared or not at blood pressure re-pressed for 30 min was observed.Results Both of the onset time of controlled hypotensionduring operation and controlled hypotension effect achieved satisfactory results between two groups.The needed time that the blood pressure re-pressed to 90% of basic blood pressure in group S was longer than that of group N and did not appearbounce high blood pressure.Conclusion Using sevoflurane for controlled hypotension in intracranial aneurysmal surgery can achieve satisfactory effect.