倾斜的位置对在全身麻醉下接受脊椎手术的患者的大脑氧化的影响
Rahul Goyal1, Bhavna Hooda2, Shalendra Singh3
1Department of Anaesthesiology & Critical Care, Armed forces Medical College, Pune, India.
Journal of perioperative practice
|March 28, 2025
概括
全身麻醉可以影响大脑稳态,但近红外光谱 (NIRS) 监测在脊椎手术中倾斜定位时没有显著影响大脑氧化. 对于高风险患者,推使用NIRS.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 手术监测 手术监测
背景情况:
- 全身麻醉通过心血管变化影响器官,大脑平衡效应基本上不受监测.
- 近红外光谱学 (NIRS) 提供了对大脑氧化量的非侵入性监测.
- 在麻醉期间评估大脑平衡需要客观的神经监测方法.
研究的目的:
- 为了研究躺卧对在全身麻醉下患者的大脑氧化的影响.
- 评估近红外光谱在倾斜定位期间用于神经监测的实用性.
主要方法:
- 研究了44名在全身麻醉下躺着接受脊柱手术的患者.
- 区域氧和 (rSO2) 用NIRS.测量了卧卧和卧卧的位置.
- 减少rSO2>20%被认为具有临床意义.
主要成果:
- 在全身麻醉下俯卧导致血压和心率显著下降.
- 潮结束时的二氧化碳水平显著增加,特别是在倾斜的位置.
- 卧卧姿和卧卧姿之间没有观察到大脑氧化量的显著差异,尽管有一名患者有视力丧失.
结论:
- 接近红外光谱的监测是建议的患者,并发症或经历长时间的手术在容易的位置.
- 在麻醉和定位变化期间,NIRS可以帮助评估大脑氧化率.
- 进一步的研究可能会探索特定的患者群体或手术持续时间,其中NIRS最有利.
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