异丙酚-瑞芬太尼麻醉下不同人工气道模式对大脑皮质功能区手术术中唤醒试验效果的影响

目的 评价经喉罩插管和经鼻气管插管两种人工气道模式对靶控输注(target controlled infusion,TCI)异丙酚-瑞芬太尼麻醉下大脑皮质功能区手术术中唤醒试验效果的影响.方法 择期行大脑皮质功能区手术的患者20例,将致病灶位于语言中枢以及同时位于语言中枢和运动中枢的患者称为喉罩组(Ⅰ组),将致病灶位于...

Effect of laryngeal make airway or nasotracheal intubation airway on intra-operative wake-up test in patients during operation on cerebral cortical functional area under propofol-remifentanil anesthesia

Objective To investigate the effect of laryngeal mask airway(LMA)and transnasal tracheal intubation airway on intraoperative wake-up test in patients during operation on cerebral cortical functional area under propofol-remifentanil anesthesia administered by target controlled infusion(TCI).Methods Twenty ASA Ⅰ-Ⅱ patients undergoing neurosurgery on cerebral cortical functional area were divided into two groups(n=10)by different surgery sites:Group Ⅰ-in the language centre or/and motive centre,Group Ⅱ-in the motive centre.TCI technique was used in induction and maintenance during propofol-remifentanil anesthesia in two both groups.Under deep sedation,an LMA was insetted in group Ⅰ,whereas nasotracheal intubation in group Ⅱ.We carried on wake-up test during the operation,and defined the wake-up time as the duration from interruption of anesthesia to the moment patients responded to commands,and recorded the variables of mean arterial pressure(MAP),heart rate(HR),and end tidal carbon dioxide(PETCO2)at different time-point including anesthesia induction(T1),10 min after intubation(T2)and wake-up time(T3),the corresponding target plasma concentration of propofol and remifentanil and adverse events during wake-up test were also recorded simultaneously.Results All patients completed wake-up test during operation successfully.The wake-up time was(16.9±2.4)min and(15.7±1.8)min in group Ⅰ and Ⅱ respectively,without reaching significant change in both groups(P＞O.05).But during intraoperative wake-up test,the incidence of vomiting,hypercapnia and brain swelling were significantly lower in group Ⅱ(0％)than in group Ⅰ(20％)(P＜0.05).Conclusion Compared with LMA,nasotracheal intubation airway can increase the effect of wake-up test while using TCI technique with propofol-remifentail anesthesia in patients underwent operations in the site of cerebral cortical motive centre.