脑功能区手术唤醒麻醉与清醒程度的研究

目的分析大脑功能区手术唤醒麻醉中对病人清醒程度的影响因素,提出脑功能区定位时态的概念.方法对15例病人采用丙泊酚靶控输注（TCI）给药,按作者提出的脑功能区定位时态评判标准对清醒程度进行评估.结果术中唤醒状态下语言清晰者10例,指令应答准确8例,无痛9例;颅内压正常10例.定位时态优5例,良8例,差2例.13例唤醒麻醉手术过程顺利,2例因脑组织膨胀未定位.结论丙泊酚TCI给药是脑功能区手术唤醒术较好的麻醉方法.应用脑功能区定位时态的概念对提高麻醉清醒质量有临床指导意义.

Research of anesthesia for awake craniotomy and consciousness level

Objective To retrospectively analyze the factors associated with anesthesia influencing consciousness level of the patients during the operation in eloquent brain areas and put forward the conception of status of eloquent area mapping.Methods Fifteen patients were anesthetized by propofol target-controlled infusion(TCI).The consciousness level of the patients was assessed according to the author's evaluation criteria for localization of the eloquent brain area.Results Ten patients had clear speech in awake state,8 had the ability to accurately response to instruction,9 felt no pain,and 10 had normal intracranial pressure.Surgical status was excellent in 5 cases,good in 8,and poor in 2.Surgery in the eloquent brain area was achieved successfully in 13 cases,and failed to be localized because of brain swelling in 2.Conclusion Propofol TCI is a good anesthesia method for maintaining waking state of the patient during surgery in the eloquent brain area.Application of the conception of status of eloquent area mapping has a clinically instructional value in improving the consciousness level of the patient.