The clinical investigation of retention respiration intubation general anesthesia in craniocerebral operation / 中国医师进修杂志

ABSTRACT

Objective To study the effect and safety on the retention respiratory inhalation general anesthesia in craniocerebral operation.Methods Eighty-six patients undergoing craniocerebral operation were divided into conventional anesthesia group (group A) and retention respiratory anesthesia group (group B) by random digits table method with 43 cases each.Group A was given conventional induction and intubation,administration order:midazolam 0.05 mg/kg,fentanyl 2-4 μ g/kg,cisatracurium 0.2-0.3 mg/kg,propofol 1.0-1.5 mg/kg;group B was given rapid induction and intubation,administration order:midazolam 0.05 mg/kg,fentanyl 2-4 μg/kg,propofol 1.0-1.5 mg/kg,succinylcholine 1.5 mg/kg.The 2 groups after intubation done by Ohmeda 7100 anesthesia machine control respiration,trace pump continuous infusion of propofol and remifentanil,and maintained inhaling isoflurane anesthesia.Group A was discontinuity intravenous injection atracurium.Group B was changed autonomous breathing after the succinylcholine effect disappeared,respiratory frequency according to the regulation of remifentanil infusion rate,the respiration rate remained at 8-12 times/min.The consumption of propofol and remifentanil,additional times of fentanyl,intraoperative airway pressure,partial pressure of carbon dioxide in end expiratory gas (PE TCO2),intraoperative body movement,airway pressure,extubation time,OAA/S score after extubation 15 min and untoward reaction were recorded.Results There were no statistical differences in operation time,intraoperative body movement,intraoperative airway pressure and PETCO2 between the 2 groups (P＞ 0.05).The consumption of propofol and remifentanil,additional times of fentanyl in group B were significantly higher than those in group A [(69.2 ± 13.7) μg/(kg·min) vs.(61.0 ± 8.2)μg/(kg·min),(0.19 ± 0.06) μ g/ (kg· min) vs.(0.15 ± 0.05) μ g/ (kg· min),1.5 times vs.0 time],there were statistical differences (P＜ 0.05).The extubation time in group B was significantly shorter than that in group A [(6.4 ±3.2) min vs.(11.3 ± 4.5) min],the OAA/S score after extubation 15 min in group B was significantly lower than that in group A [1 (1-3) scores vs.2(1-3) scores],there were statistical differences between the 2 groups (P ＜ 0.05).Conclusion Retention respiration intubation general anesthesia patients of craniocerebral operation can early recover,extubation time is significantly shorter,it is a safe and effective anesthesia method.