术中磁共振成像技术用于神经外科手术麻醉处理.PDF

·160 · 南方医科大学学报（JSouthMedUniv） 2011;31(1) ·临床研究· 术中磁共振成像技术用于神经外科手术的麻醉处理 孙 立，时文珠，公茂伟，米卫东，张 宏 解放军总医院麻醉手术中心，北京 100853 摘要：目的探讨术中磁共振成像技术用于神经外科手术的围术期麻醉处理理特点。方法30 例颅内肿瘤患者术前经过安 全筛查，采用磁兼容的麻醉机、监护仪及输注泵系统，在气管插管静吸复合麻醉下行术中磁共振成像开颅肿瘤切除术。记 录患者手术时间、术中磁共振成像次数、成像时间、成像相关时间（即从成像准备工作开始至重新开始手术的时间）、因磁 共振成像延长的时间、首次磁共振成像前后体温变化和围术期与麻醉、成像相关的意外及并发症。结果30 例患者均顺利 完成手术，手术时间为9.33±2.82 h ，平均成像次数为1.8 次（1~6 次），每次成像时间为29.24± 10.10 min ，成像相关时间为 43.83± 10.23 min ，手术延长时间为92.63±28.31 min。首次成像后2 h 体温显著高于麻醉诱导后。围术期未发生与成像及 麻醉相关的意外及并发症。结论除遵循一般神经外科麻醉的处理原则外，麻醉医生需针对术中磁共振成像的特殊环境 及特殊过程，更多关注围术期安全防范、术中监测及麻醉调控。 关键词：磁共振成像；麻醉；神经外科 中图分类号：R445 文献标志码：A 文章编号：1673-4254（2011）01-0160-04 Anesthetic management for neurosurgery using intraoperative magnetic resonance imaging SUN Li, SHI Wen-zhu, GONG Mao-wei, MI Wei-dong, ZHANG Hong Anesthesia and Operation Center, General Hospital of PLA, Beijing 100853, China Abstract: Objective To analyze the anesthetic management for neurosurgery using intraoperative magnetic resonance imaging (iMRI). Methods Thirty patients with intracranial tumor received MRI for preoperative safety screening and the operation was performed with general anesthesia and support by MRI-compatible machines. The operative time, frequency and duration of MRI, MRI-related time (from the preparation for MRI to the beginning of the surgery), time delay by MRI, body temperature at the initial iMRI and special issues related to the scanning and perioperative anesthesia were recorded. Results Thirty patients successfully completed the operations without any incidents related to anesthesia or scanning. The mean frequency of MRI was 1.8, the mean duration of MRI was 29.24± 10.1