Intraoperative wake-up procedure with propofol and laryngeal mask for optimal excision of brain tumour in eloquent areas
Intraoperative wake-up procedure with propofol and laryngeal mask for optimal excision of brain tumour in eloquent areas
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术中使用异丙酚和喉罩进行唤醒程序，以实现口才区域脑肿瘤的最佳切除
DOI：
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发表时间：
2001
影响因子：
2
通讯作者：
Takamitsu Yamamoto
中科院分区：
文献类型：
--
作者：
C. Fukaya;Y. Katayama;A. Yoshino;Kazutaka Kobayashi;M. Kasai;Takamitsu Yamamoto
这是第一篇论文描述了一种使用喉罩进行清醒开颅手术的新技术。清醒开颅术联合异丙酚输注，对于口才好的脑肿瘤的最佳切除，已变得越来越流行。在清醒开颅手术期间，不进行气管插管，丙泊酚的输注被限制在使患者刚刚镇静的剂量内。这种睡眠-觉醒过程有时会导致难以控制脑容量，特别是在脑肿瘤有显著质量影响的患者，因为异丙酚足够的镇静往往会导致高碳酸血症。我们报告了一种使用喉罩的术中唤醒程序，该程序能够在足够剂量的异丙酚下进行全身麻醉，并在机械辅助通气下控制脑容量。在皮质标测开始之前，异丙酚的输注将完全终止，因此患者可以在5-15分钟内苏醒。肿瘤切除完成后，在足够剂量的异丙酚下再次诱导全身麻醉。如果需要，喉罩可以临时移除并轻松地重新定位。根据我们的经验，这项技术适用于脑肿瘤的最佳切除，特别是对非常肥胖或有非常大病变的患者。
This is the first thesis describing a new technique for awake craniotomy using a laryngeal mask. Awake craniotomy with propofol infusion has become increasingly popular for the optimal excision of brain tumours located in eloquent areas. During awake craniotomy, tracheal intubation is not performed and propofol infusion is limited to within doses which render the patient just sedated. This asleep-awake procedure is occasionally associated with difficulty in controlling brain volume, especially in patients with a significant mass effect of their brain tumours, since sufficient sedation with propofol tends to cause hypercapnea. We report an intraoperative wake-up procedure employing a laryngeal mask, which enables general anaesthesia to be performed at a sufficient dose of propofol and with control of the brain volume under mechanically assisted ventilation. Before the beginning of cortical mapping, propofol infusion is completely terminated, so allowing the patient to wake up within 5-15 min. Following completion of the tumour excision, general anaesthesia is re-induced at a sufficient dose of propofol. The laryngeal mask can be temporarily removed and repositioned with ease, if necessary. In our experience, this technique is applicable for the optimal excision of brain tumours, especially in patients who are very obese or those who have very large lesions.
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影响因子：
4.1
作者：
OJEMANN, G;OJEMANN, J;BERGER, M
通讯作者：
BERGER, M
影响因子：
4.8
作者：
HAGLUND, MM;BERGER, MS;OJEMANN, GA
通讯作者：
OJEMANN, GA
影响因子：
4.1
作者：
PUCE, A;CONSTABLE, RT;ALLISON, T
通讯作者：
ALLISON, T
功能皮质和皮质下白质位于神经胶质瘤内。
影响因子：
4.8
作者：
Skirboll,SS;Ojemann,GA;Berger,MS;Lettich,E;Winn,HR
通讯作者：
Winn,HR