摘要
目的 比较颅脑手术中相同 MAC( 1.3 MAC)的异氟醚和异氟醚 / N2 O麻醉时的脑血流CO2 反应性。方法 选择 ASA - 级颅内肿瘤病人行择期开颅手术 2 0例 ,随机分为两组 :异氟醚组( ) :吸入 1.5 %异氟醚、空气、氧气 ;异氟醚 / N2 O组 ( N) :吸入 0 .8%异氟醚、( 60～ 65 ) % N2 O、氧气 ,每组 10例。在 Pa CO2 为 5 .3 k Pa、3 .7k Pa时分别抽取动脉、颈内静脉球部血行血气分析。根据 Fick公式计算 Ca O2 、Cjv O2 及 Ca- v DO2 ,并计算每组的脑血流相对 CO2 反应性。结果 全部病人术中血液动力学稳定 ,N组的脑血流相对 CO2 反应性〔( 4 5 .8± 7.2 ) %· k Pa- 1〕显著大于 组〔( 2 6.3± 6.8) %·k Pa- 1〕( P<0 .0 5 )。结论 异氟醚 / N2 O麻醉时的脑血流相对 CO2 反应性较相同 MAC( 1.3 MAC)
Objective To compare the cerebral blood flow reactivity to CO 2 during exposure to equipotent dose of isoflurane or isoflurane/N 2O anesthesia.Methods Twenty ASA grade Ⅰ Ⅱ patients with brain tumors wrere scheduled for selective craniotomy.Anesthesia was induced with intravenous fentanyl,propofol and succinylcholine.After tracheal intubation,the lungs were ventilated.Patients were randomly assigned to two groups:1.5% isoflurane(group Ⅰ,n=10)and 0.8% isoflurane in 60% 65% nitrous oxide(group N,n=10).After opening the dura,arterial and jugular venous bulb blood samples were taken when PaCO 2 was 5.3 kPa and 3.7 kPa respectively for blood gas analysis.According to Fick principle,the level of CaO 2,CjvO 2 and Ca vDO 2 were calculated.MAP,CVPand HR were recorded simultaneously,and CO 2 reactivity were calculated.Results The hemodynamics,SaO 2 and CaO 2 all remaind stable during these procedures.CO 2 reactivity,calculated as the percent change in Ca vDO 2 per kPa change in PaCO 2,was larger in group N than in group Ⅰ(45.8%±7.2%·kPa -1 vs 26.3%±6.8%·kPa -1 ,P<0.05).Conclusion Cerebral blood flow reactivity to CO 2 is more remarkable in the isoflurane/N 2O anesthesia than in isoflurane anesthesia.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
1999年第1期21-23,共3页
Chinese Journal of Anesthesiology
