丙泊酚与瑞芬太尼复合吸入麻醉在颅内动脉瘤夹闭术中的临床应用

目的探讨丙泊酚、瑞芬太尼复合吸入麻醉在颅内动脉瘤夹闭术中应用的临床意义。方法选择52例颅内动脉瘤行夹闭术的患者，采用丙泊酚、瑞芬太尼复合异氟醚或七氟醚，术中间断注射顺式阿曲库铵，并持续监测平均动脉压（MAP）、中心静脉压（CVP）、心率（HR）、心电图（ECG）、脉搏、血氧饱和度（SP02）和呼气末二氧化碳分压（PetC02）。结果52例手术全部实施控制性降压麻醉，51例实施动脉瘤颈夹闭术，1例实施动脉瘤包裹术。术毕13例手术室内拔除气管内导管，其余均未清醒带管回ICU或神经外科ICU。结论丙泊酚、瑞芬太尼复合吸入麻醉诱导迅速，维持平衡好，患者对气管导管耐受性好。适用于颅内动脉瘤夹闭术的麻醉。

Experiences of intravenous-inhalation anesthesia in intracranial

Objective To investigate the effect of intravenous-inhalation anesthesia with propofol-remifentanil and sevofluraneon intracranial aneurysm surgery. Methods 52 patients of intracranial aneurysm surgery were adopted intra- venous-inhalation anesthesia with propofol-remifentanil and sevoflurane, injected cisatracurium during operations. It was necessary to monitor MAP, CVP, HR, ECG, SPO2, PetCO2 in all cases. Results 51 patients with clipping and 1 wrapping intracranial aneurysm were controlled hypotension with propofol-remifentanil and sevoflurane. The patients were treated continuously in ICU or neurosurgical ICU with endotracheal tube in postoperative period, except 13 in general ward after extubated. Conclusion Intravenous-inhalation anesthesia with propofol-remifentanil and sevoflurane is feasible and safe in intracranial aneurysm surgery.