摘要
本文总结了60例施行带蒂大网膜脊髓移植治疗外伤性截瘫的麻醉处理。应用冬眠合剂1号或小儿冬眠1号与γ羟基丁酸钠诱导,并间断辅以氯胺酮或英诺佛合剂,术中保留自主呼吸或贝英回路吸O_2的方法安全、可靠、操作简便。但存在气管插管时心血管副反应较大,术中部分病人血液动力学不够稳定、肌松差、苏醒慢等缺点;应用安定-硫贲妥钠-阿曲可林-芬太尼快速诱导,0.15‰阿曲可林与1％普鲁卡因复合液静脉点滴。本法不仅效果确切,镇痛完善,而且肌松良好,术中血压平稳,术后苏醒快。术中辅助吸入低浓度(0.5～1％)异氟醚或氨氟醚。术中经加速度肌松监测仪监测,肌松起效及恢复时间与正常人无多大差别。本组病虽少,但不失为一安全有效的麻醉方法,值得今后继续应用和探讨。
The anesthetic management of 60 cases of traumatic paraplegia undergoing mass omentum-spinal transplantation is reviewed. All but 3 of them were operated under general anesthesia. The first scheme of general anesthesia, The first scheme of general anesthesia, applied in most of the cases, included slow induction with lytic cocktail No. lor children's Ixtic cocktail plus sodium r-hydroxybutyrate, intubation, and maintenance of anesthesia with supplementary ketamine or innovar, and even enflurane or isoflurane in some cases. The patients continued spontaneons breathing or were put on Brain's breathing system in inhale oxygen. This technique was safe, reliable and easy to practise; but had such disadvantages as remarkable cardiovascular response to intubation, hemodynamic instability and slow recovery of awareness. The second scheme, which was then developed and applied in 3 patients, included rapid induction with the mixture of diazepam, thiopentol sodium, atracurium and fentanyl; intubation and mechanized ventilation; and maintenance with intravenous procaine general anesthetic ( 1 % procaine and 0.15% atracurium). This technique produced reliable surgical anesthesia, complete analgesia, good muscle relaxation, steady blood pressure and quick recovery of awareness. It seems that the latter scheme is effective and superior to the first one, though its further clinical application and observation are needed.
出处
《徐州医学院学报》
CAS
1991年第3期182-184,共3页
Acta Academiae Medicinae Xuzhou
关键词
脊髓移植
麻醉
静脉麻醉
anesthesia
mass omentum-spinal transplantation
