【摘要】 目的比较大脑皮质功能区手术唤醒麻醉中依托咪酯与丙泊酚联合瑞芬太尼麻醉的效果。方法择期行大脑皮质功能区胶质瘤手术患者30例,随机分为依托咪酯组(E组,n=15)和丙泊酚组(P组,n=15),联合瑞芬太尼,在头皮神经阻滞、切口浸润麻醉和硬脑膜表面麻醉下,所有药物微量泵人工控制持续输注,根据患者反应、手术刺激调整给药速度。在唤醒状态下应用术中皮质电刺激确定功能区边界切除肿瘤。评价脑功能定位时态,记录循环、呼吸变化、唤醒时间、术中术后并发症、术中记忆。结果两组术中脑功能区定位时态优良率(E组80%,P组86%)、循环变化无显著性差异。P组有1例出现呼吸抑制。E组唤醒时间短于P组(P<0.05)。两组患者均未出现术中痛苦记忆。结论依托咪酯、丙泊酚均可提供良好脑功能区定位时态,但依托咪酯唤醒时间较丙泊酚更短。更多还原

【Abstract】 Objective To explore the effects of remifentanil combined with propofol or etomidate in providing conscious sedation for awake craniotomy in eloquent cortex surgery.Methods Thirty patients undergoning glioma removal in the cerebral cortical functional area were randomly divided into two groups: the etomidate group and the propofol group(n=15).The status of eloquent areas mapping,respiratory variables and hemodynamic stability were assessed,also the recall time and complications were documented.Results There were no differences in status of eloquent areas mapping or hemodynamic and respiratory variables between the two groups.Respiratory complications occurred in 1 patient in the propofol group,but there were significant differences in recall time between the two groups(etomidate,321 s;propofol,410 s).Conclusion Etomidate and propofol are good in the status of eloquent areas mapping,but etomidate is superior to propofol in recall time.更多还原