Thoracoscopic surgeries usually require single-lung ventilation under general anesthesia because of the need to obtain a sufficient working space.In patients with impaired pulmonary function,if the patient can undergo...Thoracoscopic surgeries usually require single-lung ventilation under general anesthesia because of the need to obtain a sufficient working space.In patients with impaired pulmonary function,if the patient can undergo general anesthesia,a more selected collapse of the lung is considered to be beneficial for intraoperative oxygenation.The selective bronchial blockade of the lobe to be resected has been reported by several investigators （1-3）.Mukaida and coworkers first reported thoracoscopic surgery for pnenmothorax under local and epidural anesthesia in 1998 in high-risk patients contraindicated for general anesthesia （4）.展开更多
Background Localization of sensory cortical areas during the operation is essential to preserve the sensory function. Intraoperative direct electrostimulation under awake anesthesia is the golden standard but time-con...Background Localization of sensory cortical areas during the operation is essential to preserve the sensory function. Intraoperative direct electrostimulation under awake anesthesia is the golden standard but time-consuming. We applied 3T high field blood oxygen level-dependent （BOLD） functional magnetic resonance imaging （fMRI） to identify the relationship between glioma and cortical sensory areas preoperatively and to guide intraoperative direct electrostimulation for quick and precise localization. Methods Five glioma patients with sensory cortex involvement by or next to the lesion had preoperative BOLD fMRI to determine the spatial relationship of cortical sensory areas to the tumours. Bilateral hand opposite movement was performed by these patients for fMRI. Precentral and postcentral gyri were identified by electrical stimulation during the operation. Karnofsky Performance Status scores of the patients＇ pre- and postoperative and the role of BOLD fMRI were evaluated. Results The cortical sensory areas were all activated in five glioma patients involving postcentral gyrus areas by BOLD fMRI with bilateral hand opposite movement. The detected activation areas corresponded with the results from cortical electrical stimulation. Conclusions The relationship between cortical sensory areas and tumour can be accurately shown by BOLD fMRI before operation. And the information used to make the tumour resection could obtain good clinical results.展开更多
文摘Thoracoscopic surgeries usually require single-lung ventilation under general anesthesia because of the need to obtain a sufficient working space.In patients with impaired pulmonary function,if the patient can undergo general anesthesia,a more selected collapse of the lung is considered to be beneficial for intraoperative oxygenation.The selective bronchial blockade of the lobe to be resected has been reported by several investigators （1-3）.Mukaida and coworkers first reported thoracoscopic surgery for pnenmothorax under local and epidural anesthesia in 1998 in high-risk patients contraindicated for general anesthesia （4）.
基金This work was supported by a grant from the country ＂11th Five-Year Plan＂ （No. 2007BAI05B08）, Major Program of the National Natural Science Foundation of China （No. 30730035） and Key Project of Chinese National Programs for Fundamental Research and Development （973 Program, No. 2007CB512500）.
文摘Background Localization of sensory cortical areas during the operation is essential to preserve the sensory function. Intraoperative direct electrostimulation under awake anesthesia is the golden standard but time-consuming. We applied 3T high field blood oxygen level-dependent （BOLD） functional magnetic resonance imaging （fMRI） to identify the relationship between glioma and cortical sensory areas preoperatively and to guide intraoperative direct electrostimulation for quick and precise localization. Methods Five glioma patients with sensory cortex involvement by or next to the lesion had preoperative BOLD fMRI to determine the spatial relationship of cortical sensory areas to the tumours. Bilateral hand opposite movement was performed by these patients for fMRI. Precentral and postcentral gyri were identified by electrical stimulation during the operation. Karnofsky Performance Status scores of the patients＇ pre- and postoperative and the role of BOLD fMRI were evaluated. Results The cortical sensory areas were all activated in five glioma patients involving postcentral gyrus areas by BOLD fMRI with bilateral hand opposite movement. The detected activation areas corresponded with the results from cortical electrical stimulation. Conclusions The relationship between cortical sensory areas and tumour can be accurately shown by BOLD fMRI before operation. And the information used to make the tumour resection could obtain good clinical results.
