听觉诱发电位指数在神经外科介入治疗中的应用_临床医学论文.docVIP

听觉诱发电位指数在神经外科介入治疗中的应用_临床医学论文 听觉诱发电位指数在神经外科介入治疗中的应用_临床医学论文 【摘要】 目的 探讨听觉诱发电位指数(AAI)、靶控输注及喉罩应用于神经外科介入治疗的可行性及有效性。方法 将40例ASAⅡ～Ⅲ级，动脉瘤分级Ⅱ～Ⅳ级接受神经外科介入治疗全身麻醉的患者随机分为A、B两组，每组20例，两组均应用丙泊酚靶控瑞芬太尼阿曲库铵静脉维持麻醉，插入喉罩进行机械通气。A组为AAI指导组，通过维持AAI值于20～25来调节丙泊酚的靶浓度值；B组为对照组，凭借血流动力学参数来调节丙泊酚的靶浓度值。记录麻醉期间血流动力学及AAI的变化、麻醉药物用量、术毕清醒时间、拔管时间及有无发生术中知晓。结果 40例患者均安全顺利经过介入治疗过程, 两组患者血流动力学指标及术毕拔管时间差异无统计学意义(Pgt;0.05)，A组丙泊酚用量及术毕清醒时间少于B组(0.05)，两组均未发现术中知晓。结论 AAI作为一项新的麻醉深度监测指标可被有效地应用于神经外科介入治疗全麻监测，实现给药个体化，提高麻醉安全性，减少术中知晓的发生率。 【关键词】 听觉诱发电位指数； 颅内动脉瘤； 介入 【Abstract】 Objective To investigate the effectiveness and feasibility of using auditory evoked potential index(AAI), target～Ⅲ, aneurysm degreeⅡ，who were undergoing neurosurgical endovascular treatment under general anesthesia were randomly divided into two groups(n=20 each), all the patients were maintained anesthesia with propofolgroup), adjusted TCI concentration of propofol by maintaining AAI from 20 to 25; GroupⅡ(control group), according to hemodynamic data to adjust TCI concentration of propofol. All the following data were recorded, such as hemodynamic data, AAI, the dosage of anesthetic drug, awaked time and the time of extubated LMA after operation, whether happened awareness during operation. Results The operations on all patients were successful. There were no differences between two groups on hemodynamic data and the time of extubated LMA after operation (Pgt;0.05).The dosage of propofol and awaked time after operation of groupⅠwere lower than that of group Ⅱ (0.05).There was no awareness happening during operation. Conclusion As a new reference of measuring the depth of anesthesia, AAI can be effectively used during general anesthesia for the operation of endovascular embolization in intracranial aneurysms, to achieve medication individually, elevate the safety of anesthesia and reduce awareness rate during operation. 【Key words】 Auditory evoked potential index；Intracranial aneurysm；Endovascular treatment 随着神经外科介入技术的不断发展，颅内动脉瘤治疗也由外科手术转向介入性微创治疗。它具有重复性强、定位准