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- Title
Application of Propofol-remifentanil in Awake Craniotomy Surgery.
- Authors
YANG Juan; JIAO Shu-lan; HUANG Rui-ping; WANG Lu; ZHANG Yu-long; ZHAO Ning-hui
- Abstract
Objective To investigate the availability, safety, and patient's satisfaction of propofol -remifentanil application in awake craniotomy surgery. Methods We retrospectively reviewed 14 cases of gliomas in eloquent cortex from August 2011 to December 2013.14 cases of gliomas in eloquent cortex were resected undergoing craniotomy in awaking anesthesia (Asleep-awake-asleep). The enrolled patients included 5 cases of male, and 9 cases of female, the age was 42 ∼ 59, ASA I - H. All of patients underwent preoperative CT, MRI scan and enhanced scan. Imaging findings showed language function glioma (including 8 cases of adjacent Broca's area, and 6 cases in nearby Wernicke's area), postoperative pathological results certified the diagnosis. All patients were anesthetized with 0.2% Ropivacaine in nail place and surgical incision line. And Remifentanil 0.03 - 0.05 ug/(kg.min) and Propofol in 75-100 ug/(kg.min) were injected intravenously with micropump. From local infiltration anesthesia till the completion of craniotomy, we kept patients in sleep state with infusion drugs of high dosage. We kept patients in awake state with reduction of intravenous drugs gradually until removal of the tumor. We communicate with patients constantly, language cortex localization were monitored using continuous number counting during removal of the tumor. The patients slept again with deepen anesthesia until the end of the surgery. The patients were monitored during operation including changes of hemodynamics, Spo2, PetCO2, blood gas analysis, the complications and the satisfaction for surgical procedure was evaluated. Results All patients underwent in surgery conscious state with stable hemodynamics. There were no conspicuous complications, sedation score was (3 ± 0.4) . Pain score of all of patients was below 4 points. There was no hypoxemia, hypercapnia, and acid-base balance disorders during operation, satisfaction rate of patients and surgeon was well. Conclusion Remifentanil and propofol can be used securely in awake craniotomy surgery on the basis of local infiltration anesthesia, and under appropriate adjustments intravenous amount of remifentanil and propofol, and can reduce postoperative complications and improve the patient's quality of life.
- Publication
Journal of Kunming Medical University / Kunming Yike Daxue Xuebao, 2014, Vol 35, Issue 6, p55
- ISSN
2095-610X
- Publication type
Article