本文選題：羅哌卡因　切入點(diǎn)：神經(jīng)阻滯　出處：《中南大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討頭部神經(jīng)阻滯復(fù)合靜脈全麻在神經(jīng)外科麻醉中的臨床應(yīng)用。 方法40例因額顳頂部占位擬行病灶切除術(shù)患者隨機(jī)分為羅哌卡因神經(jīng)阻滯組(R組)和對(duì)照組(C組),每組20例。R組于誘導(dǎo)前選擇耳顳神經(jīng)、眶上神經(jīng)和枕大神經(jīng)、枕小神經(jīng)以0.5%羅哌卡因行神經(jīng)阻滯。C組不進(jìn)行神經(jīng)阻滯。常規(guī)麻醉誘導(dǎo)行氣管插管后用丙泊酚和瑞芬太尼靶控輸注維持麻醉。記錄不同時(shí)間點(diǎn)的心率、平均動(dòng)脈壓、腦電雙頻指數(shù),以及丙泊酚與瑞芬太尼使用總量、拔管時(shí)間,術(shù)后2h、6h、24h、48h疼痛視覺(jué)模擬評(píng)分(VAS),術(shù)后麻醉相關(guān)并發(fā)癥。 結(jié)果兩組患者術(shù)中血流動(dòng)力學(xué)均穩(wěn)定,R組瑞芬太尼使用總量少于C組(P0.05)。兩組拔管時(shí)間、丙泊酚使用總量、術(shù)后并發(fā)癥發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組的VAS在2h和6h差別有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后24h和48h,兩組VAS評(píng)分差別無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論頭部神經(jīng)阻滯復(fù)合靜脈全麻可減少顱腦手術(shù)中瑞芬太尼用量,患者血流動(dòng)力學(xué)穩(wěn)定,術(shù)后鎮(zhèn)痛效果良好。
[Abstract]:Objective to investigate the clinical application of head nerve block combined with intravenous general anesthesia in neurosurgery. Methods A total of 40 patients were randomly divided into ropivacaine block group (n = 20) and control group C (n = 20). The auricular and temporal nerve, supraorbital nerve and occipital nerve were selected before induction in each group (n = 20). The small occipital nerve was treated with 0.5% ropivacaine. No nerve block was performed in group C. the anesthesia was maintained by target-controlled infusion of propofol and remifentanil after endotracheal intubation during routine anesthesia induction. Heart rate and mean arterial pressure were recorded at different time points. The bispectral index of EEG, the total amount of propofol and remifentanil, the extubation time, the visual analogue score of pain at 2 h, 6 h, 24 h and 48 h after operation, and the complications associated with anesthesia were observed. Results the total amount of remifentanil used in group R was less than that in group C (P 0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P 0.05), but there was no significant difference in VAS between the two groups at 2 h and 6 h, and at 24 h and 48 h after operation, there was no significant difference in VAS score between the two groups (P 0.05). Conclusion head nerve block combined with intravenous general anesthesia can reduce the dosage of remifentanil in craniocerebral surgery.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R614

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