摘要
目的:分析环泊酚复合瑞芬太尼全麻在ROSA机器人辅助脑深部电刺激术(DBS)中的作用。方法:选取2021年6月—2023年6月在南京脑科医院实施ROSA机器人辅助脑深部电刺激术的100例患者作为研究对象,根据患者术中麻醉方式的不同,将其分为对照组(n=50)和观察组(n=50),其中对照组行利多卡因和罗哌卡因局部麻醉,观察组行环泊酚复合瑞芬太尼全麻。比较两组患者手术相关指标、丘脑底核(STN)频率、镇静效果、血清相关指标、应激反应等。结果:观察组手术时间、拔管时间短于对照组,术中出血量、颅内积气体积低于对照组,且观察组STN频率高于对照组,记录长度短于对照组(P<0.05)。术毕时,观察组镇静评分为高于对照组,差异具有统计学意义(P<0.05)。与术前相比,两组患者应激反应均有所波动,观察组应激反应波动幅度较对照组更小,观察组血清指标优于对照组,麻醉恢复期不良反应发生率低于对照组(P<0.05)。结论:对于实施ROSA机器人辅助DBS的患者,在术中采用环泊酚复合瑞芬太尼全麻,能获得较好的麻醉效果,且能够缩短手术时间、减少围术期患者应激反应的波动水平,有效抑制患者血清S-100β、NSE水平,有助于保护脑组织。
Objective:To analyze the effect of general anesthesia with propofol and remifentanil in ROSA robot-assisted deep brain stimulation(DBS).Methods:A total of 100 patients who underwent ROSA robot-assisted DBS in Nanjing Brain Hospital from June 2021 to August 2023 were enrolled.According to the different anesthesia methods used during the surgery,the enrolled patients were divided into the control group(n=50)and the observation group(n=50).The control group received local anesthesia with lidocaine and ropivacaine,and the observation group received general anesthesia with propofol and remifentanil.Surgical indicators,subthalamic nucleus(STN)frequency,sedative effect,serum related indicators,stress response of patients were compared between two groups.Results:The observation group had shorter operative and extubation time compared to the control group,with lower intraoperative bleeding and intracranial gas volume.The observation group had higher STN frequency and shorter recording length than the control group(P<0.05).At the end of the surgery,the sedation scores of patients in the observation group was higher than those in the control group,with a significant difference(P<0.05).Both groups of patients showed fluctuations in stress response.The fluctuation amplitude of stress response in the observation group was smaller than that in the control group.The serum indicators in the observation group were better than those in the control group,and the incidence rate of adverse reactions in the observation group during anesthesia recovery were lower than those in the control group(P<0.05).Conclusion:For patients undergoing ROSA robot-assisted DBS,general anesthesia of propofol combined with remifentanil can achieve good anesthesia effects,shorten operative time,lower the fluctuation level of perioperative stress response,and effectively inhibit serum S-100βand NSE levels,which has a protective effect on brain tissue.
作者
蒋慧慧
徐娇
陆军
李锦汶
章文斌
JIANG Huihui;XU Jiao;LU Jun;LI Jinwen;ZHANG Wenbin(Department of Anesthesiology,Nanjing Brain Hospital,Nanjing 210029,China;Department of Anesthesiology,the Eighth Affiliated Hospital of Sun Yat sen University,Shenzhen 518033,China)
基金
江苏省重点研发计划(BE2022049,BE2022049-1)。
