摘要
开颅手术是临床上对神经外科疾病患者进行治疗的常用方法。开颅手术的麻醉要重点注意维持血流动力的稳定,降低术中的应激反应,避免血压波动过大,同时又要保证良好的脑组织灌注,降低术后并发症的发生,保障患者平稳快速地苏醒。在神经外科手术中,上头架、切头皮、锯颅骨等操作可对患者产生强烈的刺激,导致交感神经系统兴奋,易引起血压增高和心动过速,增加颅内压升高、颅内出血等发生风险,威胁患者的生命安全。近年来,随着超声可视化技术的发展,头皮神经阻滞可以更加安全广泛的运用于开颅手术中,有效地减轻手术刺激造成的血流动力学波动,提供更加完善的镇痛效果,且可以降低并发症的发生。本文就头皮神经阻滞在颅脑手术中应用的概况作一综述。
Craniotomy is a common method to treat patients with neurosurgical diseases.The anesthesia of craniotomy should focus on maintaining the stability of hemodynamics,reducing intraoperative stress response and avoiding excessive fluctuation of blood pressure.Meanwhile,it should ensure good brain tissue perfusion,reduce the occurrence of postoperative complications and ensure patients to wake up smoothly and quickly.In neurosurgical operations,such operations as scalp cutting and skull sawing can generate strong stimulation to patients,lead to sympathetic nervous system excitement,easily cause increased blood pressure and tachycardia,increase the risk of intracranial pressure and intracranial hemorrhage,and threaten the safety of patients'lives.In recent years,with the development of ultrasonic visualization technology,scalp nerve block can be used more safely and widely in craniotomy,which can effectively reduce the hemodynamic fluctuation caused by surgical stimulation,provide more perfect analgesic effect,and reduce the occurrence of complications.This paper reviews the application of scalp nerve block in craniocerebral surgery.
作者
黄川
王力峰
叶军明
HUANG Chuan;WANG Li-feng;YE Jun-ming(Gannan Medical University;Department of Anesthesiology,the First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)
出处
《赣南医学院学报》
2021年第2期208-213,共6页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
关键词
头皮神经阻滞
开颅手术
术后镇痛
Scalp nerve block
Craniotomy
Postoperative analgesia
