摘要
目的观察0.25%罗哌卡因复合0.25%利多卡因切口浸润对丙泊酚-瑞芬太尼全凭静脉麻醉开颅术中血流动力学、麻醉药物使用量及苏醒期疼痛的影响。方法 30例幕上肿瘤切除术患者随机双盲均分为两组。分别给予0.25%罗哌卡因+0.25%利多卡因混合液(浸润组)或生理盐水(对照组)切口浸润后立即切皮。术中采用丙泊酚和瑞芬太尼维持麻醉。记录诱导前、切口浸润前、切皮、钻颅骨、缝皮时的MAP、HR;记录丙泊酚、瑞芬太尼总用量。记录拔管后5min的疼痛VAS评分以及苏醒期Riker镇静-躁动(SAS)评分。结果切皮、钻颅骨、缝皮时浸润组MAP均明显低于、HR明显慢于对照组(P<0.05或P<0.01)。浸润组丙泊酚和瑞芬太尼总用量、拔管后5minVAS评分和苏醒期SAS评分均明显低于对照组(P<0.01)。结论 0.25%罗哌卡因和0.25%利多卡因混合液切口浸润麻醉,能有效地稳定丙泊酚-瑞芬太尼全凭静脉麻醉开颅术中血流动力学,减少麻醉药物使用量,缓解苏醒期疼痛和躁动,而且能快捷方便地实施,值得在开颅术中常规应用。
Objective To explore the effects of scalp infiltration with 0.25% ropivaeaine mixed with 0.25% lidoeaine on hemodynamic stability, intraoperative anesthetic requirements, and recovery status in patients receiving craniotomy under propofol remifentanil total intravenous anesthesia （TIVA）. Methods A prospective randomized double blind control trial was conducted on 30 patients having resection of a supratentorial tumor. Midazolam, vecuronium, propofol and remifentanil were used to induce and maintain TIVA. Just before skin incision, the patients in ropivacaine group received scalp infiltration with 0.25% ropivacaine plus 0.25% lidocaine, compared to those in control group who lust received normal saline. For both groups, MAP and HR were measured at the time points of before induction, before scalp infiltration, skin incision, skull incision and suture. The total amount of propofol and remifentanil used were also recorded. Visual analog scale （VAS） scores at the time of 5rain after extubation and sedation agitation scale （SAS） scores at the time of recovery were also recorded. Results MAP and HR values measured at the time points of skin incision, skull incision and suture, the total amount of propofol and remifentanil used, and VAS and SAS scores in the ropivacaine group are all significant lower than those in the control group respectively （P〈0.05 or P〈0.01）. Conclusion Scalp infiltration with 0.25% ropivacaine mixed with 0.25%lidocaine, which can be easily implemented during surgery, could stabilize bemodynamic, reduce anesthetic requirements, alleviate analepsia period pain and agitation in craniotomy.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第3期216-218,共3页
Journal of Clinical Anesthesiology
