不同麻醉方案对幕上肿瘤切除术后患者麻醉复苏的影响

摘要

目的：：比较2种不同麻醉方案对幕上肿瘤切除术患者麻醉复苏的影响。方法：66例患者随机分为2组,分别在脑电双频指数( BIS)指导下使用丙泊酚-瑞芬太尼麻醉( PR组)和七氟烷-舒芬太尼麻醉( SS组)。评估患者术后自主呼吸恢复时间、拔管时间和对简单指令有反应的时间。同时记录患者改良镇静评分≤1分、格拉斯哥昏迷评分=15分、疼痛VAS评分0.05)。 SS组患者术后Aldrete评分=10分、简易精神状态量表=30分和格拉斯哥昏迷评分=15分时间均早于PR组患者(P0.05)。结论：在BIS指导下,行幕上肿瘤切除术患者使用七氟烷-舒芬太尼麻醉和丙泊酚-瑞芬太尼麻醉后苏醒时间无明显不同,七氟烷-舒芬太尼麻醉有加快此类患者神经功能恢复的趋势。%Objective:To compare the effects of two different anaesthetic methods on the anesthesia recovery of patients after supratentorial tumor resction. Methods:Sixty-six patients were randomly divided into the propofol-remifentanil ( PR group ) and sevoflurane-sufentanil( SS group) . The PR group and SS group were anaesthetized using propofol-remifentanil and sevoflurane-sufentanil under the bispectral index( BIS) monitor,respectively. The time of the spontanous breathing recovering,extubation and response in two groups were evaluated after operation. The time at Simplified Sedation Score(SSS) less than or equal to 1,Glasgow Coma Scale(GCS) equal to 15,Pain Visual Analogue Scale(PVAS) less than 4,Mini-mENTAL sTATE(MMS) equal to 30 and Aldrete Score(AS) equal to 10 in two groups were recorded. Results:The differences of the spontanous breathing recovering time,extubation time and response time between two group were not statistically significant(P>0. 05). The time at the postoperative AS equal to 10,MMS equal to 30 and GCS equal to 15 in SS group was sooner than those in PR group(P0. 05). Conclusions:The anesthesia recovery time between the propofol-remifentanil and sevoflurane-sufentanil in patients after supratentorial tumor resction under the bispectral index monitor has no significant difference. The sevoflurane-sufentanil can improve the neural function recovery of patients.