【摘要】 目的探索舒芬太尼、异丙酚复合异氟醚静吸复合麻醉控制性降压,在脑动脉瘤夹闭术中实施管理方法。方法术前均行CT、MRI、DSA确认为脑动脉瘤患者40例。术中实施控制性降压.控制MAP为8.0～9.33kPa,脑动脉瘤夹闭后停止降压,使MAP升至10.64～11.97 kPa,手术结束后均带管人住ICU病房,呼吸机支持治疗。结果术中血液动力学均较平稳,均未出现反跳性高血压,脑松弛状态良好。术毕1～2h内拔管32例,4～6h内拔管8例,40例患者均无麻醉死亡,术后恢复良好。结论舒芬太尼、异丙酚复合异氟烷控制性降压用于脑动脉瘤夹闭术效果好,血液动力学稳定,具有脑保护作用,术后恢复良好。更多还原

【Abstract】 Objective To explore a rational, and effective management of anesthesia, which is using sufentanil, propofol combined with the isoflurane-inhalation anesthesia in controlled hypotension in clipping the aneurysm. Methods Forty cases of patients who were confirmed diagnosis by CT,MRf and DSA. All the patients were controlled hypotension and made MAP at 8 ～9. 33 kPa. Stop controlled hypotension after cerebral aneurysm clipping,made the MAP increase to 10. 64～11. 97 kPa,after the opreation send the patients to ICU wards,and accepted ventilator support treatment. Results The hemodynamics were smooth and without rebound hypertension. The brain was in a good state of relaxation. Thirty-two cases patients were extubated 1～2 h after send to ICU,8 cases were extubation in 4~6 h. There was no anesthesia death in 40 patients,and all the patients recovered well after operations. Conclusion Using sufentanil, propofol combined with isoflurane inhalation anesthesia in clipping cerebral aneurysms surgery, the effect of controlled hypotension was good, the hemodynamic was stable, and all the patients had a protection for cerebral and a good recovery after operations.更多还原