重型颅脑损伤急诊手术的麻醉探讨

目的探讨急诊重度颅脑损伤手术的麻醉处理方法。方法32例重度颅脑损伤患者采用静脉诱导下行气管内插管，麻醉维持用异丙酚4-8mg／（kg·h），间断静脉注射维库溴铵，吸入低浓度异氟醚。结果全组病例麻醉管理中无呕吐、误吸，麻醉效果好，无麻醉死亡；术中、术毕血流动力学Sp02虽与术前有显著差异i但绝大部值均在正常范围，提示内环境平衡，术后均带管安返病房。结论异丙酚静脉持续输注复合低浓度吸入麻醉是重度颅脑损伤患者行急诊手术麻醉的安全有效方法。

Anaesthesia of Emergency Operation in Severe Craniocerebral Injury

Objective To investigate the anaesthesia method for emergency operation in severe craniocerebral injury. Methods Thirty-two patients with severe craniocerebral injury received endotracheal intubation after intravenous induction and were exposed to propofol of 4-8 mg/kg/h for maintenance of anesthesia, with intermittent intravenous injection of vecuronium and inhalation of low concentration isoflurane. Results Vomitting and aspiration were absent in entire group during anaesthesia, with favorable anaesthesia effect and without death from anaesthesia. Although there were substantial differences in hemodynamics parameters such as SpO2 between during and at the end of operation and before operation, yet the majorities of the parameters were within normal range, indicating homeostatic equilibrium. All cases returned safely to ward with intubation. Conclusion Continous intravenous infusion of propofol combined with low-concentration inhalation of isoflurane for anaesthesia induction can be safe and potent method for anesthesia in severe craniocerebral injury patients underoing emergency surgey.