Research And Evaluate Of The Breath Catheter For Intraoperative Wake-up On The Brain Area Matching Program

Objective Design some externalglottis breath catheter to solve the conflict between breath and speak in intraoperation wake-up during general anesthesia.Methods We designed and made three model catheters (type Ⅰ type Ⅱ and typeⅢ). These catheters were used to60patients who had general anesthesia, including20paitents were intraoperation wake-uped.Ruselts All paitents had good ventilation, air passage pressure and blood gas analysis were right. All could speak with catheter. Type Ⅱ and type Ⅲ were distincter and smoother than type Ⅰ (P<0.01).Conclusion Patient can speak distinctly and smoothly with these catheter in operation. These series of catheters have good ventilation, were safety for mechanical ventilation and general anesthesia. Type Ⅱ and type Ⅲ are better. These catheters solved the conflict between breath and speak in intraoperation wake-up, and can enhance safety of brain operation with intraoperation wake-up greatly. Objective To compare two different doses of anesthetic drugs on the brain area matching program intraoperative wake-up results in patients with the level of consciousness.Methods The brain areas involved to epileptic foci in20cases of surgery. Ventilation:11cases of endotracheal intubation,9cases involving language areas of the esophagus using self-developed nasopharyngeal catheter, with good ventilation effectiveness, and to speak with management. Narcotic drug match were randomly divided into A, B groups, Group A with propofol50～80ug/kg·min+remifentanyl0.1～0.15ug/kg·min cisatracurium0.1mg/kg·h, dosage usual dose by matching its half-life of the pump before the wake-up drug; Group B with a higher dose of remifentanyl (0.30.5ug/kg·min)+low-dose propofol and cisatracurium compound. Intraoperative BP, HR, recovery time and level of consciousness.Results Group A of patients in BP, HR is more volatile than Group B,p<0.05; recovery time Group A of25.3±3.4min was longer than Group B18.6±3.2min, p<0.05; Alertness rating, Group B good rate100%is better than Group A(75%excellent).Conclusion The intraoperative wake-up ventilation mode, the authors developed their own sound to outside ventilation device-esophageal nasopharyngeal catheter procedure to solve the language areas of airway management and ventilation can not speak after the conflict. Program on anesthesia showed that Group B with a larger dose of remifentanil combined with small doses of propofol and cisatracurium anesthesia available adequate depth of anesthesia, mechanical ventilation to ensure patient safety and comfort. Of the operator convenience, wake-up time after treatment in patients with rapid recovery and a smooth, clear and high quality, can take control speech, much better than Group A by matching program commonly used dose. In this study, the intraoperative wake-up anesthesia, ventilation means of achieving a true sense of the "anesthesia-awake-anesthesia," the AAA mode rather than "asleep-awake-asleep," the AAA model.