Kulikova A S, Sel'kov D A, Kobyakov G L, Shmigel'skiy A V, Lubnin A Yu
Anesteziol Reanimatol. 2015 Jul-Aug;60(4):4-8.
Awake craniotomy is a "gold standard"for intraoperative brain language mapping. One of the main anesthetic challenge of awake craniotomy is providing of optimal sedation for initial stages of intervention. The goal of this study was comparison of different technics of anesthesia for awake craniotomy. Materials and methods: 162 operations were divided in 4 groups: 76 cases with propofol sedation (2-4mg/kg/h) without airway protection; 11 cases with propofol sedation (4-5 mg/kg/h) with MV via LMA; 36 cases of xenon anesthesia; and 39 cases with dexmedetomidine sedation without airway protection. Results and discussion: brain language mapping was successful in 90% of cases. There was no difference between groups in successfulness of brain mapping. However in the first group respiratory complications were more frequent. Three other technics were more safer Xenon anesthesia was associated with ultrafast awakening for mapping (5±1 min). Dexmedetomidine sedation provided high hemodynamic and respiratory stability during the procedure.
清醒开颅手术是术中脑语言图谱绘制的“金标准”。清醒开颅手术主要的麻醉挑战之一是在干预初始阶段提供最佳镇静。本研究的目的是比较清醒开颅手术不同麻醉技术。材料与方法：162例手术分为4组：76例采用丙泊酚镇静（2 - 4mg/kg/h）且无气道保护；11例采用丙泊酚镇静（4 - 5mg/kg/h）并通过喉罩进行机械通气；36例采用氙气麻醉；39例采用右美托咪定镇静且无气道保护。结果与讨论：90%的病例脑语言图谱绘制成功。各组间脑图谱绘制成功率无差异。然而，第一组呼吸并发症更频繁。其他三种技术更安全。氙气麻醉与用于图谱绘制的超快苏醒（5±1分钟）相关。右美托咪定镇静在手术过程中提供了较高的血流动力学和呼吸稳定性。
