脊柱侧弯矫形术中唤醒试验麻醉探讨

目的：探讨异丙酚联合瑞芬太尼在脊柱侧弯矫形术中唤醒试验的可控和可行性。方法：13例择期行脊柱侧弯矫形手术患者,ASA分级Ⅰ～Ⅱ级。全麻诱导用咪达唑仑0.05mg/kg、异丙酚1.5～2.0mg/kg、芬太尼2μg/kg、罗库溴铵0.6mg/kg静脉注射,麻醉维持采用丙泊酚6～10mg/（kg·h）,瑞芬太尼0.1～0.3μg/（kg·min）持续输注,间断注射肌松药罗库溴胺0.15mg/kg,维持MAP较术前降低10%～15%。唤醒前1h停用肌松药,15min将异丙酚减半,5min时停用异丙酚,将瑞芬太尼减至0.025～0.05μg/（kg·min）。结果：唤醒成功用时为（468±72）s,唤醒质量高。结论：该麻醉方法用于唤醒试验平稳、安全和可控性强,技术成熟,操作方便,不失为一种满意的麻醉方法。

Anesthesia investigation on intraoperative wake-up tests in patients undergoing scoliosis surgery

Objective：To investigate the controllability and applicability of an intraoperative wake-up test using propofol-remifen-tanil anaesthesia during scoliosis surgery.Methods：Thirteen ASAⅠ～Ⅱpatients undergoing scoliosis surgery were included.Anesthesia was inducted with midazolam（0.05 mg/kg）,propofol（1.5～2.0 mg/kg）,fentanyl（2 μg/kg） and rocuronium（0.6 mg/kg）,and was maintained with continuous infusion of propofol 6～10 mg/（kg·h）] and remifentanil 0.1～0.3 μg/（kg·min）] and intermittent i.v.of rocuronium（0.15mg/kg）.MAP was accepted if it decreaesd by 10%-15% on the level of blood pressure of pre-opemtion. Rocumnium was stopped ahead of 1 h before wake-up test, propofor was decreased to half-dose ahead of 15 min and stopped ahead of 5 rain before wake-up test, and remffentanil was decreased to 0.025-0.05μg/（kg.min） ahead of 5 rain before wake-up test. Results：The intraopemtive wake-up time was （468±72）s,and the quality of wake-up was satisfactory.Conclusion：This anaesthetic regime is stable,safe and controllable in routine clinical practice and the procedure is easy to manipulate, which is satisfactory in anesthesia practice.