| Objective and significance:Convex brain tumor is a brain tumor on the lateral side of the cerebral hemisphere,mainly including brain tumors in the frontal,parietal,occipital and temporal lobes of the cerebral hemisphere and the lateral fissure,with glioma and meningioma are the most common.Surgical resection remains the key strategy for the treatment of current convex brain tumor.In the resection of convex brain tumor,monitored anesthesia care(MAC)and general anesthesia(GA)were applied.The safety and feasibility of MAC and whether MAC is more favorable for intraoperative anesthesia and postoperative recovery in patients with convex brain tumors were verified by assessing various clinical indicators intraoperatively and postoperatively,and the satisfaction of surgeons and anesthesiologists.Methods:Using a prospective single-center randomized controlled trial,72 patients were randomly divided into MAC group and GA group by completely random measures.One day before surgery,the patients were introduced with this trial in detail,and signed informed consent.Anxiety was evaluated using self-rating anxiety scale(SAS).The preoperative imaging data were collected.Intraoperatively,resection of convex brain tumor was conducted under MAC and GA,respectively.The heart rate,blood oxygen saturation,systolic pressure,diastolic pressure,mean arterial pressure,and bispectral indexes of electroencephalogram were recorded at each time point.Exercise,language,and sensory function(including hand and foot exercise,arithmetic operation,reading,tactile,algesia,temperature sense,etc.)in the MAC group were monitored.Vigilance/calm was scored.The duration of surgery,anesthesia and regaining consciousness,as well as the satisfaction of surgeons and anesthesiologists to anesthesia were recorded.The rate of postoperative recovery(including eating,out-of-bed activity,length of hospital stay,etc.)and postoperative complications were recorded.Imaging data within 72 hours after surgery were collected.A psychological questionnaire survey was conducted on the patients before discharge,and the follow-up was performed for 3 months.Preoperative,intraoperative and postoperative clinical data were collected,and a statistical analysis was carried out to draw a conclusion.Results:(1)Totally 75 patients,with superficial brain tumor and in line with inclusion criteria,were collected.Later 3 patients were excluded and the rest 72 patients were included into the experiment.Clinical data of the 72 patients was collected.These patients were randomly divided into MAC Group and GA Group,with 36 ones in each group.(2)There was no statistically significant difference,between GA Group and MAC Group,in such baseline information as gender,age,BMI,lesion location,pathological classification and past medical history(p >0.05).(3)Compared with the GA Group,the MAC Group was administered less types and dosage of anesthetic and experienced less anesthetic side effect,with statistically significant difference(p<0.05).(4)The MAC Group experienced higher level of tumor excision than the GA Group,with statistically significant difference(p<0.05).(5)Compared with the GA Group,the MAC Group experienced less hospital stays and postoperative complication,with statistically significant difference(p<0.05).Conclusion:MAC applying in the resection of convex brain tumor brings great changes to surgery in neurosurgery.Intraoperatively,patients under a comfortable state cooperate with surgeons and anesthesiologists to display language,body movement and visual function,full function is retained,tumor resection is expanded,and tumors were the maximum safely resected.MAC shows obvious advantages compared with GA,and MAC is expected to be the main anesthesia method for the resection of convex brain tumors in the future. |
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