头皮神经阻滞复合七氟醚在颅脑手术中的临床应用
Clinical Application of Scalp Nerve Block Combined with Sevoflurane in Craniotomy
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摘要: 目的 探讨头皮神经阻滞复合七氟醚在颅脑手术中的应用效果.方法 将2013年3月至2015年3月平顶山市第二人民医院收治的55例行开颅手术患者随机分为观察组和对照组,其中观察组28例,采用头皮神经阻滞复合七氟醚麻醉;对照组患者27例,采用七氟醚静吸复合舒芬太尼麻醉.观察2组患者诱导前、诱导后5min、切皮时、破脑膜、手术结束时和拔管后5 min时平均动脉压(MAP)、心率(HR)变化;比较2组患者术后躁动情况、麻醉时间、苏醒时间以及舒芬太尼用量.结果 对照组患者切皮时、破脑膜、手术结束时以及拔管后5 min的MAP和HR均有显著性升高,且显著高于相同时刻观察组,差异具有统计学意义(P<0.05);观察组患者术后躁动程度低于对照组,差异具有统计学意义(P<0.05);2组患者麻醉时间相比差异无统计学意义(P>0.05),观察组苏醒时间明显短于对照组,且舒芬太尼用量也显著小于对照组,差异有统计学意义(P<0.01).结论行头皮神经阻滞的颅脑手术患者术中生命体征平稳、舒芬太尼用量少、术后苏醒快、躁动发生率低,值得推广应用.Abstract: Objective To explore the application efficacy of scalp nerve block combined with sevoflurane in craniotomy.Methods Fifty-five patients undergoing craniotomy in pingdingshan second people's hospital of henan province from Mar 2013 to Mar 2015 were randomly divided into observation group(n=28) and control group(n =27).The scalp nerve block combined with sevoflurane was performed in observation group and the sevoflurane intravenous inhalational combined with sufentanil was performed in control group.The changes of MAP and HR were observed before induction,5min after induction,skin incision,break the meninges,operation end and 5min after catheter removal.The agitation scale after operation,anesthesia duration,awaking time and dosage of sufentanil were compared.Results MAP and HR at skin incision,break the meninges,operation end and5 min after catheter removal in control group were significantly increased than those before operation, and significantly higher than those in observation group at same stage of operation, with statistically significancedifferences(P <0.05).The agitation scale of observation group was lower than that of control group, with statistically significance difference(P <0.05).There was no significance difference between two groups in anesthesia duration(P>0.05),the awaking time in observation group was significantly shorter than that in control group and the dosage of sufentanil was significantly reduced in observation group(P<0.05).Conclusion Scalp nerve block combined with sevoflurane used in craniotomy has advantages in stable vital signs,rapid awaking,less dosage of sufentanil and lower score of agitation,which is suitable for clinical application.
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Key words:
- Scalp nerve block /
- Sevoflurane /
- Craniotomy
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[1]徐海华,盛绚宇,于海涛,等.舒芬太尼对颅脑手术患者麻醉诱导期间血流动力学及应激反应的影响[J].中国现代医生,2015,53(13):118-121. [2]熊振辉,马建军.全凭静脉麻醉和静吸复合全麻在颅脑手术中应用效果分析[J].2013,10(20):77-79,84. [3] [3]PAPANGELOU A,RADZIK B R,SMITH T,et al.A review of scalp blockade for cranial surgery[J].J Clin Anesth,2013,25(2):150-159. [4]付小武,孙研炜.瑞芬太尼复合丙泊酚麻醉在颅脑手术中的应用[J].吉林医学,2013,34(10):1867-1868. [5]陈美红,谢柳昭,李刚.罗哌卡因用于阻滞头皮神经的效果护理探讨[J].临床医学工程,2013,20(2):243-244. [6]赵卫兵.罗哌卡因头皮神经阻滞在开颅手术中的应用[J].四川医学,2011,32(11):1730-1731. [7] [7]KIM H S,LEE S J,KIM C S,et al.Effect of triamcinolone added to scalp nerve block for postoperative pain management of Moyamoya disease[J].Korean J Anesthesiol,2011,61(2):173-174. [8]曾横宇,张曦,程灏,等.头皮神经阻滞在脑功能区手术中的镇痛作用[J].中国康复理论与实践,2010,16(8):725-727. [9]张新疆,聂晓飞.神经外科全麻后复苏患者恢复期间躁动原因与处理[J].中国实用医药,2012,7(6):56-57. [10]王勇.舒芬太尼对脑外科麻醉诱导时血流动力学的影响[J].中国实用神经疾病杂志,2013,16(16):27-28. [11]孔素梅.外伤性颅内血肿清除术应用舒芬太尼麻醉的效果观察[J].中国实用神经疾病杂志,2015,18(15):127. [12]马树勇,赵永忠.左旋布比卡因头皮神经阻滞在开颅手术中的应用[J].中国临床研究,2014,27(5):533-534,536. [13]聂继英,李建华,李艳,等.丙泊酚复合舒芬太尼在经DSA行脑动脉瘤栓塞术中的效果评价[J].江西医药,2014,49(6):538-539. [14]李宗艳,刘鑫,孙福德.头皮神经阻滞联合七氟醚麻醉在小儿钻孔引流术中的应用[J].重庆医学,2013,42(26):3110-3111. [15]聂芳,王安奎,周颖,等.罗哌卡因头皮神经阻滞在高血压脑出血开颅术中的应用[J].中国临床研究,2013,26(4):376-377. [16]文四成,陈潜沛,欧阳天纬,等.不同浓度罗哌卡因用于超声引导下肌间沟臂丛神经阻滞的麻醉效果[J].临床麻醉学杂志,2014,30(5):472-475. [17]谢柳昭,李刚.罗哌卡因用于头皮神经阻滞效果的护理对策[J].中外医学研究,2013,11(13):74-75. -
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