头部神经阻滞联合静脉全麻在神经外科手术麻醉中的应用价值

发布时间：2018-03-21 06:28

本文选题：@头部神经阻滞　切入点：神经外科手术　出处：《陕西医学杂志》2016年12期 　论文类型：期刊论文

【摘要】：目的:探讨头部神经阻滞联合静脉全麻在神经外科手术麻醉中的应用价值。方法:选取拟行首次颅内占位切除术的36例患者为研究对象。根据随机对照原则分为研究组(神经阻滞组)和对照组(单纯静脉全麻组)。采用视觉模拟评分法(VAS)对术后2h、6h、24h、48h进行疼痛评分,记录两组术中瑞芬太尼和丙泊酚使用总量。结果:瑞芬太尼和丙泊酚总用量比较显示,研究组平均瑞芬太尼总用量(1319.6±584.2μg)明显低于对照组的(2438.7±967.5μg),差异有显著统计学意义(P0.05);研究组平均丙泊酚总用量(1210.1±520.5mg)稍低于对照组(1449.8±422.7mg),差异无统计学意义(P0.05)。术后VAS评分比较结果显示,术后2hVAS、6hVAS评分组间差异有统计学意义(P0.05),术后24hVAS、48hVAS评分组间差异无统计学意义(P0.05)。结论 :头部神经阻滞联合静脉全麻可减少颅脑手术中麻醉维持镇痛药物瑞芬太尼的用量,并且术后具有较好的镇痛效果,是神经外科开颅手术理想的麻醉方法。
[Abstract]:Objective: to investigate the value of head nerve block combined with intravenous general anesthesia in neurosurgical anesthesia. Methods: 36 patients undergoing the first intracranial space occupying resection were selected as study objects. The study group (nerve block group) and the control group (simple intravenous general anesthesia group) were assessed with visual analogue score (VASS) for pain at 2 h, 6 h, 24 h and 48 h, respectively. The total amount of remifentanil and propofol were recorded in both groups. Results: the total dosage of remifentanil and propofol were compared. The mean total dose of remifentanil in the study group (1319.6 卤584.2 渭 g) was significantly lower than that in the control group (2438.7 卤967.5 渭 g / g), and the average total dosage of propofol was 1210.1 卤520.5 mg / g in the study group, which was slightly lower than that in the control group (1449.8 卤422.7 mg / g). There was significant difference in VAS score between the two groups at 2 h after operation (P 0.05), but there was no significant difference in VAS score at 24 h after operation (P 0.05). Conclusion: head nerve block combined with intravenous general anesthesia can reduce the dosage of remifentanil, a maintenance analgesic during craniocerebral surgery. Postoperative analgesia is an ideal anaesthesia for neurosurgery craniotomy.
【作者单位】：辽宁省辽阳市中心医院麻醉科;陕西省榆林市第二医院神经外科;
【基金】：辽宁省科技基金(2008225021-1,2013225021-1)
【分类号】：R614

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