摘要
目的比较脊柱神经外科手术中吸入麻醉与全凭静脉麻醉的效果差异。方法选取神经外科进行脊柱神经外科手术的100例患者,随机分为吸入麻醉组(50例)和全凭静脉麻醉组(50例),吸入麻醉组采用七氟醚吸入麻醉,静脉麻醉组使用丙泊酚维持麻醉,比较两组患者围手术期的血液生理学指标平均动脉压(MAP),心率(HR),血氧饱和度(SpO2),呼末二氧化碳分压(P ET CO2)和脑氧供指标颈静脉氧饱和度(SjvO2)和体感诱发电位(SEP)。结果静脉麻醉组平均动脉压高于吸入麻醉组(P<0.05)。两组患者心率均低于麻醉前数值,静脉麻醉组诱导后10 min心率下降,低于吸入麻醉组(P<0.05)。静脉麻醉组患者脑氧供指标与麻醉前无显著差异,吸入麻醉组SjvO2明显升高,说明脑耗氧量下降。吸入组与静脉组SEP出现波幅或者潜伏期异常的发生率差异无显著性。结论两种麻醉方法仅能维持脊柱神经外科手术中血流动力学稳定,吸入麻醉可降低脑耗氧量,静脉麻醉可维持正常体感诱发电位。
Objective To investigate the effect of inhalation anesthesia and total intravenous anesthesia（TIVA） in spinal neurosurgery. Methods 100 case of patients were choose from nerve surgery department and divided into two groups, Inhalation anesthesia group （50 case） and TIYA group （50 case）. The patients of anesthesia group were ued Sevoaquane and TIVA group used to maintain anesthesia. The MAP, HR, SpO2 , PzT CO2, SjvOz and SEP were detected. Results There were no apparent fluctuations of hemodynamics in both groups. HR in both groups were lower at 80 and 160 min （ P 〈0.05 ）. HR were lower at 10 rain after induction in group TIVA than that of inhalation an esthesia group （ P 〈 0.05）. SjvOz of the TIVA group patients were no significant differences comparing with those before anesthesia. The SjvO2 in the inhalation anesthesia group patients were higher than before （ P 〈 0.05 ）, which indicated that the decline of cerebral oxygen consumption. The SEP of inhalation anesthesia group were different from TIVA group. Conclusion Two anesthetic regimens are compatible during spinal neuro- surgery, with no apparent fluctuations of perioperative blood glucose. Inhalation anesthesia ean reduce the oxygen consumption. Intravenous anes thesia can be maintained normal somatosensory evoked potentials.
出处
《临床和实验医学杂志》
2013年第19期1558-1560,共3页
Journal of Clinical and Experimental Medicine
