摘要
目的:探讨不同麻醉药物对幕上脑肿瘤患者诱导麻醉后颅内压及脑灌注压的影响。方法:选择我院神经外科接受开颅手术治疗的患者60例,根据随机数字表法分为观察组和对照组,观察组患者应用芬太尼1μg/kg+咪达唑仑0.1mg/kg+异丙酚2 mg/kg+琥珀酰胆碱2mg/kg,对照组患者应用舒芬太尼1μg/kg+咪达唑仑0.1mg/kg+异丙酚2 mg/kg+琥珀酰胆碱2mg/kg。监测并比较两组患者诱导麻醉前后ICP及CPP的变化。结果:(1)ICP的比较:插管后即刻、插管后5min、插管后15min及切皮后,两组患者ICP均逐渐升高,与诱导前比较差异均具有统计学意义(P<0.05)。开骨瓣后两组患者ICP均逐渐降低,但仍高于诱导前水平(P<0.05),开硬膜后两组患者ICP均恢复至诱导前水平。(2)观察组患者CPP于插管后逐渐降低,插管后15min、切皮后及开骨瓣后均显著低于诱导前,差异具有统计学意义(P<0.05),开硬膜后逐渐升高。对照组患者CPP于插管后即刻、插管后15min、切皮后、开骨瓣后及开硬膜后均显著低于诱导前,其中,于插管后即刻、插管后15min、切皮后及开骨瓣后均显著低于观察组,其差异均具有统计学意义(P<0.05)。结论:幕上脑肿瘤患者在麻醉诱导后出现ICP升高,CPP降低,而舒芬太尼较芬太尼对ICP及CPP影响更加明显。
Objective：To explore the different anesthetic agents on intracranial pressure and cerebral perfusion pressure in patients with supratentorial brain tumors after induction of anesthesia.Methods：60 patients receiving craniotomy were randomly divided into observation group and the control group, the observation group patients used fentany 1μg/kg＋midazolam 0.1mg/kg＋propofol 2 mg/kg＋succinylcholine 2mg/kg control group patients used sufentanil 1μg/kg＋midazolam 0.1mg/kg＋propofol 2 mg/kg＋succinylcholine 2mg/kg.ICP and CPP changes of the two groups before and after anesthesia were compared. Results： （1）ICP comparison intubation immediately after intubation 5min,after intubation 15min after incision,two groups of patients ICP gradually increased,compared with before the induction of the differences were statistically significant （P〈0.05）.The two groups of patients after open flap ICP gradually decreased,but still higher than before the induction level （P〈0.05）,the two groups of patients after open subdural ICP were restored to the induction of the level before.Observation group patients CPP after intubation decreased gradually,after 15min,after incision and open the flap after intubation were significantly lower than before the induction,the difference was statistically significant （P〈0.05）,gradually open the dura mater liter high. Immediately after the control group in patients with CPP in intubation, intubation after 15min,after incision,open flap and open subdural significantly lower than before the induction,which,immediately after intubation,intubation after 15min,skin incision and open flap after significantly lower than that of the observation group,the differences were statistically significant （P〈0.05）. Conclusion：After induction of anesthesia in patients with supratentorial brain tumor the ICP elevated,the CPP reduce,compare with compared with fentanyl, sufentanil is more pronounced impact on ICP and CPP.
出处
《中国医药导刊》
2014年第2期268-269,共2页
Chinese Journal of Medicinal Guide
