Frost Elizabeth A M, Booij Leo H D J
Mount Sinai Medical Center, New York, NY 10029, USA.
Curr Opin Anaesthesiol. 2007 Aug;20(4):331-5. doi: 10.1097/ACO.0b013e328136c56f.
This review summarizes the current anesthetic management of patients undergoing craniotomies in the awake state.
As the practice of neurosurgery has moved towards less invasive procedures the need for prolonged, deep general anesthesia has decreased. Since brain mapping and neurophysiologic testing is an integral part of many neurosurgical techniques, the need to provide sufficient analgesia and sedation without interference with electrophysiologic monitoring is also essential.
A safe and acceptable analgesic/amnestic state for these procedures can be provided by the use of dexmedetomidine, with or without the addition of remifentanil.
本综述总结了目前清醒状态下开颅手术患者的麻醉管理。
随着神经外科手术向侵入性较小的手术方式发展，对长时间深度全身麻醉的需求减少。由于脑图谱和神经生理学测试是许多神经外科技术的重要组成部分，因此在不干扰电生理监测的情况下提供足够的镇痛和镇静也至关重要。
使用右美托咪定，无论是否加用瑞芬太尼，均可为这些手术提供安全且可接受的镇痛/遗忘状态。
