摘要
目的 研究环泊酚在帕金森患者行全麻脑深部刺激器植入术中的应用。方法 纳入2020年10月—2022年4月于南京医科大学附属脑科医院择期行脑深部刺激器植入术(DBSI)的60例帕金森患者,随机分为研究组(H组)和对照组(C组),每组30例。H组采用咪唑安定0.04 mg/kg、舒芬太尼0.25μg/kg、环泊酚0.4 mg/kg、顺苯磺酸阿曲库铵0.15 mg/kg, C组采用咪唑安定0.04 mg/kg、舒芬太尼0.25μg/kg、丙泊酚1.5 mg/kg、顺苯磺酸阿曲库铵0.15 mg/kg。两组全麻维持泵注瑞芬太尼,右美托咪定,顺苯磺酸阿曲库铵,维持脑电双频指数(BIS)值60左右。记录患者麻醉诱导前(T_(0))、麻醉诱导后(T_(1))、插气管导管后(T_(2))、 BIS值达60左右时(T_(3))、微电极测试时(T_(4))、手术结束时(T_(5))的平均动脉压(MAP)、心率(HR)、BIS值。记录BIS值达60左右的时间、微电极测试时长、手术时长。记录恶心呕吐,寒战躁动,呛咳,术中知晓等不良反应。结果 与T_(0)时比较,两组T_(1)~T_(5)时MAP明显降低,差异有统计学意义(P<0.05);HR明显减慢,差异有统计学意义(P<0.05);BIS明显降低,差异有统计学意义(P<0.05);与C组比较,H组T_(1)时MAP明显升高,差异有统计学意义(P<0.05);T_(2)时MAP明显降低,差异有统计学意义(P<0.05);H组BIS值达60左右的时间长于C组,差异有统计学意义(P<0.05)。结论 帕金森患者行全麻脑深部刺激器植入术,环泊酚诱导可维持血流动力学稳定,微电极测试时长环泊酚与丙泊酚比较差异无统计学意义,不影响微电极记录神经核团放电信号的质量和结果。
Objective To study the application of ciprofol in deep brain stimulator implantation under general anesthesia in patients with Parkinson’s disease(PD). Methods Sixty patients with PD admitted to Department of Anesthesiology, the Affiliated Brain Hospital of Nanjing Medical University from October 2020 to April 2022 were selected for elective deep brain stimulator implantation(DBSI). They were randomly divided into study group(group H) and control group(group C), with 30 cases in each group. Anesthesia induction group H received midazolam 0.04 mg/kg, sufentanil 0.25 μg/kg, ciprofol 0.4 mg/kg, atracurium cisphenylate 0.15 mg/kg, group C received midazolam 0.04 mg/kg, sufentanil 0.25 μg/kg, propofol 1.5 mg/kg, atracurium cisphenylate 0.15 mg/kg, anesthesia maintenance pump remifentanil, dexmedetomidine. Atracurium cisphenylate, maintain bispectral index(BIS) value at 60. The mean arterial pressure(MAP), heart rate(HR) and BIS values were recorded. Before induction of anesthesia(T_(0)), after induction of anesthesia(T_(1)), after insertion of endotracheal tube(T_(2)), when BIS value reached about 60(T_(3)), when microelectrode test(T_(4)), at the end of surgery(T_(5)). The time when BIS reached about 60, microelectrode test time, and operation time were recorded. Nausea and vomiting,chills and agitation,bucking,intraoperative awareness and other adverse reactions were recorded. Results Compared with T_(0),MAP decreased significantly and HR decreased significantly and BIS decreased significantly at T_(1)-T_(5)and the difference was statistically significant( P < 0. 05).Compared with group C,the MAP of group H was significantly increased at T_(1)and decreased at T_(2)and the difference was statistically significant( P < 0. 05). The time of BIS value reached about 60 in group H was longer than that in group C,and the difference was statistically significant( P < 0. 05).Conclusion Ciprofol induction can maintain the stability of hemodynamics,the microelectrode test time has no statistically significant difference bet
作者
曾琼
金晶星
李锦汶
阮义峰
陆军
章文斌
ZENG Qiong;JIN Jing-xing;LI Jin-wen;ZHANG Wen-bin(Department of Anesthesiology,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China;不详)
出处
《临床神经外科杂志》
2023年第1期62-66,共5页
Journal of Clinical Neurosurgery
基金
江苏省重点研发计划产业前瞻与关键技术项目(BE2022049)
江苏省重点研发计划产业前瞻与关键技术项目课题(BE2022049-1)
南京市卫生科技发展专项资金重点项目(ZKX20031)。
