脊椎外科手术术中唤醒试验的麻醉方法研究

摘要

Objective To investigate the anesthesia method for wake-up test in spine surgery, Methods All twenty patients, ASA grade Ⅰ to Ⅱ, were underwent spine surgery. General anesthesia was induced with midazolam 0.05 mg/kg, propofol 2 mg/kg, fentanyl 4 μg/kg, atracurium 0.5 mg/kg intravenously. Before endotra-cheal intubation 1% tetracaine was used for pharyngeal local anesthesia. The anesthesia and muscle relaxant was maintained with constant intravenous infusion of midazolam 0.4 mg/(kg·h) and atracurium 0.5 mg/(kg·h), and simultaneously inhaling sevoflurane 1.5%-2.5%. Additional fentanyl 4 μg/kg was used before incision. Ten minutes before the wake-up test, stop all medication and perform palinesthesia. Result All patients could wake up in the expected period, the average time used for wake-up was(417±82)s. All patients could move limbs following the instruction without dysphoria. Conoclusion The method of anesthesia for wake-up test is safe and controllable and could be perform conveniently.%目的 研究脊椎外科手术中术中唤醒试验(wakeuptest,WUT)的麻醉方法.方法 20例择期行脊椎外科手术病人,ASA Ⅰ～Ⅱ级,全麻静脉诱导用咪达唑仑0.05mg/kg、异丙酚2mg/kg、芬太尼4μg/kg、阿曲库铵0.5mg/kg,气管插管前用1%丁卡因咽喉部局部表而麻醉,静脉恒速输注咪达唑仑0.4mg/(kg·h)和阿曲库铵0.5mg/(kg·h),同时吸入七氟醚1.5%～2.5%维持麻醉、肌松,手术切皮前追加芬太尼4 μg/kg.需要唤醒前10min,停止所有用药,进行复苏.结果 所有病人能够在预期内唤醒,唤醒成功用时为(417±82)s,唤醒后病人无异常躁动,能够完成四肢指令动作.结论 这种麻醉方法用于唤醒试验平稳安全和可控性强,且技术成熟,操作方便.