脊椎外科手术术中唤醒试验的麻醉方法研究

目的研究脊椎外科手术中术中唤醒试验（wakeuptest，WUT）的麻醉方法。方法20例择期行脊椎外科手术病人，ASA Ⅰ～Ⅱ级，伞麻静脉诱导用咪达唑仑0．05mg／kg、异丙酚2mg／kg、芬太尼4μg／kg、阿曲库铵0．5mg／kg，气管插管前用1％丁卡因咽喉部局部表面麻醉，静脉恒速输注咪达唑仑0．4mg／（k·h）和阿曲库铵0．5mg／（kg·h），同时吸入七氟醚1．5％～2．5％维持麻醉、肌松，手术切皮前追加芬太尼4μg／kg。需要唤醒前10min，停止所有用药，进行复苏。结果所有病人能够在预期内唤醒，唤醒成功用时为（417±82）s，唤醒后病人无异常躁动，能够完成四肢指令动作。结论这种麻醉方法用于唤醒试验平稳安全和可控性强，且技术成熟，操作方便。

The research of anesthesia method for wake-up test in spine surgery

Objective To investigate the anesthesia method for wake-up test in spine surgery, Methods All twenty patients, ASA grade Ⅰ to Ⅱ, were underwent spine surgery. General anesthesia was induced with midazolam 0.05 mg/kg, propofol 2 mg/kg, fentanyl 4 μg/kg, atracurium 0.5 mg/kg intravenously. Before endotra-cheal intubation 1% tetracaine was used for pharyngeal local anesthesia. The anesthesia and muscle relaxant was maintained with constant intravenous infusion of midazolam 0.4 mg/(kg·h) and atracurium 0.5 mg/(kg·h), and simultaneously inhaling sevoflurane 1.5%-2.5%. Additional fentanyl 4 μg/kg was used before incision. Ten minutes before the wake-up test, stop all medication and perform palinesthesia. Result All patients could wake up in the expected period, the average time used for wake-up was(417±82)s. All patients could move limbs following the instruction without dysphoria. Conoclusion The method of anesthesia for wake-up test is safe and controllable and could be perform conveniently.