依托咪酯用于颅脑手术麻醉的可行性与安全性

目的观察依托咪酯用于颅脑手术,探讨其可行性及安全性。方法选取108例我院行颅脑手术患者,随机分为依托咪酯组和异丙酚组,各54例,依托咪酯组采用依托咪酯为诱导和麻醉维持用药,而异丙酚组则采用异丙酚,其余方法用药相同,观察两组的脑功能区定位时态评价、观察麻醉前、切皮、切开硬脑膜、缝皮4个时点的血压、脉搏,记录手术时间,观察术后有无麻醉并发症。结果脑功能区定位时态评价,依托咪酯组优秀率明显高于异丙酚组(P<0.01);两组手术中麻醉前、切皮、切开硬脑膜、缝皮4个时点的血压、脉搏比较P>0.05,无明显差异。术后依托咪酯组5例出现恶心呕吐,异丙酚组出现4例,术后随访两组患者均未发现有手术过程痛苦回忆史。结论依托咪酯能够提供良好脑功能区定位时态,且依托咪酯唤醒时间较短,并且有较好的脑保护作用,值得在颅脑手术麻醉中应用。

Feasibility and Safety of Etomidate for Brain Surgery Anesthesia

Objective To observe the etomidate for brain surgery, to investigate the feasibility and safety. Methods 108 cases of our hospital in neurosurgical patients were randomly divided into the etomidate group and propofol group, 54 cases, the etomidate group with etomidate for induction and anesthesia maintenance medication, while the propofol group propofol is used, the same as the rest of the method of medication to observe the evaluation of the functional areas of brain positioning of the two groups when the state observed before anesthesia, incision, cut the dura mater, skin closure, four time points, blood pressure, pulse, operation time, observed after surgery without anesthetic complications. Results The positioning of the functional areas of brain- state evaluation, relying on the excellent rate of etomidate group was significantly higher than the propofol group （P〈0.01）; two groups of surgery before anesthesia, incision, cut the dura mater, skin closure, four time points blood pressure, pulse P 〉 0.01, no significant difference. Etomidate group after five cases of nausea and vomiting, propofol group, four cases were followed up for two groups of patients were not found in the history of painful memories of a surgical process. Conclusion Etomidate can provide good brain localize functional areas of tense, and relying on etomidate wake-up time is shorter, and better brain protection, it is worth in the brain of anesthesia.