Orliaguet G, Nguyen J P, Abay K, Berberich E, Melon E, Duvaldestin P
Département d'Anesthésie-Réanimation, Hôpital Henri-Mondor, Créteil.
Ann Fr Anesth Reanim. 1991;10(3):301-3. doi: 10.1016/s0750-7658(05)80837-8.
Five cases are reported of peroperative awakening in order to obtain patient cooperation during stereotaxic procedures. General anaesthesia was induced with 0.25 mg.kg-1 midazolam, 1.5 to 2 micrograms.kg-1 fentanyl, and 0.1 mg.kg-1 vecuronium. Maintenance was obtained with isoflurane, nitrous oxide, and small doses of fentanyl. Isoflurane inhalation was discontinued 30 to 40 min before the time of awakening required by surgery. Once expiratory isoflurane concentration reached a level less than or equal to 0.1%, nitrous oxide administration was stopped, and 0.5 mg flumazenil administered. After surgical checking, on the fully awake patient of the efficiency of thalamic stimulation and the lack of any motor deficit, anaesthesia was deepened again, with either isoflurane or a non benzodiazepine intravenous agent. All five patients recovered rapidly and calmly.
报告了5例术中清醒的病例，目的是在立体定向手术过程中获得患者的配合。采用0.25mg/kg咪达唑仑、1.5至2μg/kg芬太尼和0.1mg/kg维库溴铵诱导全身麻醉。用异氟烷、氧化亚氮和小剂量芬太尼维持麻醉。在手术所需的苏醒时间前30至40分钟停止吸入异氟烷。一旦呼气末异氟烷浓度达到小于或等于0.1%的水平，停止给予氧化亚氮，并给予0.5mg氟马西尼。在对完全清醒的患者进行手术检查，确认丘脑刺激有效且无任何运动功能缺损后，再次用异氟烷或非苯二氮䓬类静脉药物加深麻醉。所有5例患者均迅速且平静地恢复。
