术中磁共振影像神经导航手术的麻醉管理

目的 探讨术中磁共振(iMR)影像神经导航辅助神经外科手术的麻醉管理.方法 22例神经外科手术患者采用核磁兼容或核磁可用的麻醉材料和设备,在全身麻醉(静吸复合或全凭静脉麻醉)下行iMR影像神经导航辅助颅内肿瘤切除术,术中监测心率、有创血压、脉搏血氧饱和度、呼气末二氧化碳分压、七氟醚浓度、中心静脉压以及动脉血气.结果 22例患者肿瘤的全切率从60.0%提高到86.4%.术中患者iMR扫描次数2～5次,手术时间延长1～3 h,术中未发生与麻醉和iMR相关的并发症和意外事件.结论 在iMR影像神经导航下行颅内肿瘤切除术的围术期麻醉处理中关注iMR影像神经导航外科相关的信息、手术室应用环境、麻醉技术和药物的选择以及围术期管理对患者的安全是重要的.

Anesthetic management for intraoperative magnetic resonance image-guided neurosurgery

Objective To investigate the anesthetic management for intraoperative magnetic resonance(iMR) image-guided neurosurgery.Methods Twenty-two neurosurgical patients received intracranial tumor resection via iMR image-guided system under genernal anesthesia in operation room.HR,SpO2,IBP,CVP,PETCO2 and blood gas analysis were monitored intraoperatively.Results Total tumor resection rate increased from 60.0% to 86.4% with iMR image-guided system.The operation time was prolonged for 1 to 3 hours resulting from 2 to 5 times iMR scan in each patient.No anesthesia or iMR-related complications and accidental events occurred intraoperatively in 22 cases.Conclusion Focusing on iMR-related procedure,operative enviroment,choice of anesthetic techniques and regimens as well as vigilant care are all important for the patients undergoing iMR image-guided neurosurgery.