头部神经阻滞联合静脉全麻在开颅手术麻醉中的应用

发布时间：2018-03-06 11:28

本文选题：罗哌卡因　切入点：神经阻滞　出处：《中南大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的探讨头部神经阻滞复合静脉全麻在神经外科麻醉中的临床应用。方法40例因额颞顶部占位拟行病灶切除术患者随机分为罗哌卡因神经阻滞组(R组)和对照组(C组),每组20例。R组于诱导前选择耳颞神经、眶上神经和枕大神经、枕小神经以0.5%罗哌卡因行神经阻滞。C组不进行神经阻滞。常规麻醉诱导行气管插管后用丙泊酚和瑞芬太尼靶控输注维持麻醉。记录不同时间点的心率、平均动脉压、脑电双频指数,以及丙泊酚与瑞芬太尼使用总量、拔管时间,术后2h、6h、24h、48h疼痛视觉模拟评分(VAS),术后麻醉相关并发症。结果两组患者术中血流动力学均稳定,R组瑞芬太尼使用总量少于C组(P0.05)。两组拔管时间、丙泊酚使用总量、术后并发症发生率差异无统计学意义(P0.05)。两组的VAS在2h和6h差别有统计学意义(P0.05),术后24h和48h,两组VAS评分差别无统计学意义(P0.05)。结论头部神经阻滞复合静脉全麻可减少颅脑手术中瑞芬太尼用量,患者血流动力学稳定,术后镇痛效果良好。
[Abstract]:Objective to investigate the clinical application of head nerve block combined with intravenous general anesthesia in neurosurgery. Methods A total of 40 patients were randomly divided into ropivacaine block group (n = 20) and control group C (n = 20). The auricular and temporal nerve, supraorbital nerve and occipital nerve were selected before induction in each group (n = 20). The small occipital nerve was treated with 0.5% ropivacaine. No nerve block was performed in group C. the anesthesia was maintained by target-controlled infusion of propofol and remifentanil after endotracheal intubation during routine anesthesia induction. Heart rate and mean arterial pressure were recorded at different time points. The bispectral index of EEG, the total amount of propofol and remifentanil, the extubation time, the visual analogue score of pain at 2 h, 6 h, 24 h and 48 h after operation, and the complications associated with anesthesia were observed. Results the total amount of remifentanil used in group R was less than that in group C (P 0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P 0.05), but there was no significant difference in VAS between the two groups at 2 h and 6 h, and at 24 h and 48 h after operation, there was no significant difference in VAS score between the two groups (P 0.05). Conclusion head nerve block combined with intravenous general anesthesia can reduce the dosage of remifentanil in craniocerebral surgery.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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