Application of different anesthesia ways in facial nerve monitoring during resections of acoustic neuromas / 中华神经医学杂志

ABSTRACT

Objective To investigate the feasibility and differences of two anesthetic methods (sevoflurane combined with remifentanil and propofol combined with remifentanil) in facial nerve monitoring without muscle relaxant during resection of acoustic neuromas.Methods Sixty-three patients with acoustic neuromas,admitted to our hospital from October 2011 to December 2012 and performed intraoperative monitoring of facial nerve without muscle relaxant assisted anesthesia,were collected in our study,and they were divided into two groups:sevoflurane combined with remifentanil treatment group (group S,n=32) and propofol combined with remifentanil treatment group (group P,n=31).The mean arterial pressure (MAP),heart rate (HR),intraoperative body movement and facial nerve were monitored and compared during the home invasion (T0),cuttng skin (T1),exploration of the facial nerve (T2),treatment of tumor near the brainstem (T3) and finishing of operation (T4).Results The MAP and HR were stable during the operation in patients of group P,without significant difference between each two observation time points (P＞0.05).Higher MAP and lower HR in the patients of group S at T2 and T3 were noted as compared with those in patients of group S at T0 and patients of group P at each same time point (P＜0.05).Facial nerve monitoring was completely possible and the anesthesia was effective in two groups.No obvious body movement was noted during the operation.Conclusion Two methods (sevoflurane combined with remifentanil and propofol combined with remifentanil) in facial nerve monitoring without muscle relaxant during resection of acoustic neuromas are completely possible and effective,and the latter one provides better hemodynamics.