有监测的麻醉管理在脑立体定向射频毁损手术的应用

目的探讨有监测的麻醉管理在脑立体定向射频毁损手术中的应用价值。方法对131例帕金氏病患者,在手术开始前静脉缓注2~4mg咪达唑仑或半剂至一剂的氟芬合剂进行镇痛-镇静。在术中根据患者情况静脉给予芬太尼0.05~0.1mg/次或丙泊酚1-4mg/kg/h持续泵入,在进行电生理检测前15~30min停止追加药物,以保证患者能清醒配合。全程监测心率(HR)、血氧饱和度(SpO2)、收缩压(SBP)等生命指标。结果患者入手术室后SBP、HR较手术前日晨明显升高20%~30%,两组之间存在统计学差异(P<0.05);应用MAC技术后与入手术室后相比,发现SBP降低28%,两组之间也存在统计学差异(P<0.05);应用MAC技术后与手术前日晨SBP比较无显著差异(P>0.05)。结论有监测的麻醉管理用于帕金森氏病患者的手术治疗是安全、有效的,值得推广。

The Investigation of Monitored Anesthesia Care during Cerebral Stereotactic Lesion Operation by Radiofrequency Technology

Objective To investigate the value of monitored anesthesia care during cerebral stereotactic lesion operation by radiofrequency technology. Method Total 131 cases of patients with Parkinson＇s disease attend the investigation. Midazolam （2-4mg） or innovar （one dose/half dose） were slowly injected to these patients from vein for relieving pain and clam. According to the situation of these patients, fentany （0.05-0.1rag/every time） or propofol （1-4mg/kg/h） were kept on pumping. The medicine adding was stop for ensuring the awake of the patients before eleetrophysiological detection. The life indexes, such as heart rat （HR） , saturation of blood oxygen （SpO2） and systolic blood pressure （SBP） , was monitored in whole range. Results The postop level of SBP and HR raised 20%-30% than preoperative level. It was significant different between them （P 〈0.05） . After using MAC, the SBP drop 28% than the level after entering the operation room. It was significant different between them （P 〈0.05） . It was no significant different between the SBP after using MAC and SBP in the preoperative morning （P 〉 0.05 ） . Conclusion The monitored anesthesia care was safety, effective and worth to spread for the operation of patients with Parkinson＇s disease.