摘要
目的 观察异丙酚、普鲁卡因对颅内压 (ICP)和脑灌注压 (CPP)的影响。方法 2 5例脑肿瘤病人随机分成异丙酚组 (D组 )和普鲁卡因组 (P组 )。局麻下钻孔于颅骨及脑膜间安置SP -2 0 0 0型颅内压监护仪 ,连续监测ICP ,同时用Colin5 0 8连续监测MAP、HR及PETCO2。静注异丙酚2mg/kg后 ,输注异丙酚 10 0～ 15 0 μg·kg-1·min-1或普鲁卡因 1mg·kg-1·min-130min ,观察ICP、MAP及CPP的变化。结果 静注异丙酚 2mg/kg后 ,两组病人ICP、MAP及CPP较诱导前有显著性降低(P <0 0 5 ) ,两组间无明显差异 (P >0 0 5 )。D组病人维持期 ,ICP持续低于诱导前水平下降幅度18%～ 47% ,MAP、CPP回升至诱导前水平 ,维持稳定。P组病人ICP也低于诱导前水平 ,下降幅度15 %～ 30 % ,和D组间比较无显著差异 (P >0 0 5 )。插管后 2 0分钟 ,MAP、CPP及HR较诱导前和D组明显增加 (P <0 0 5 )。结论 异丙酚静脉麻醉更适宜神经外科手术。
Objective To observe the effects of propofol intravenous anesthesia and procaine balanced anesthesia on intracranial pressure (ICP),mean arterial pressure (MAP)and cerebral perfusion pressure(CPP).Methods Twenty-five patients with brain tumor, scheduled for elective cranitomy,were randomly divided into two groups. Anesthesia was induced with propofol 2mg/kg in both groups ,and was maitained with infusion 0.2% propofol 100-150μg·kg -1·min -1 (D group, n=14). or infusion 2% procaine 1mg·kg -1·min -1 (P group, n=11). ICP,MAP and HR were monitored continuously.Results (1) ICP, MAP and CPP decreased significantly during induction in both groups(P<0.05). From intubation to 30 min of anesthesia, ICP remained lower than pre-induction level in both groups(P<0.05), without the significant differences between two group (P>0.05). MAP and CPP were kept stable in D group, but increased obviously 20 min after anesthesia in P group, there were significant differences between two groups (P<0.05). Conclusions Propofol intravenous anesthesia is more appropriated for the cranitomy in the patients with brain tumor.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2000年第3期133-135,共3页
Chinese Journal of Anesthesiology
关键词
颅内压
异丙酚
普鲁卡因
脑灌注压
脑肿瘤
麻醉
Propofol
Procaine
Intracranial pressure
Cerebral perfusion pressure
