摘要
应用经颅超声多普勒（ＴＣＤ）监测仪观察异丙酚、硫喷妥钠对颅脑手术患者大脑中动脉血流速度的影响。选择２２例择期手术患者，ＡＳＡＩ～ Ⅱ级，年龄 ２０～５８岁，随机分为二组：异丙酚组（２. ０ｍｇ／ｋｇ，ｎ＝１２例）和硫喷妥钠组（４ｍｇ／ｋｇ，ｎ＝１０例）。监测指标包括大脑中动脉血流速度（ＣＢＦＶ）、心率（ＨＲ）、平均动脉压（ＭＡＰ）和呼气末ＣＯ２分压。测定程序为给药前５分钟和给药后ＩＱ分钟，通过控制呼吸维持ＰｅｔＣＯ２相对恒定。结果表明，异丙酚组ＭＡＰ、搏动指数，峰值和平均大脑中动脉血流速度分别下降１３％、２９％、３１％和２０％，而硫喷妥钠组则分别下降９．７％、１４％、２２％和１３％。除给药后血管阻力指数异丙酚组明显低于硫喷妥钠组外，其余各指标两组间无显著差异。异而酚对脑循环的影响和硫喷妥钠相似，对颅脑手术患者麻醉诱导是有益的。
To observe the effects of propofol or thiopental on cerebral blood flow, twenty-two patients scheduled to undergo neurosurgery, ASA graded I to Ⅱ,aged 20 to 58 years,were assigned randomly to receiving a intravenous bolus of either 2. 0mg· kg-1 propofol (group P, n=12) or the equivalently effective dose of thiopental 4.0mg. kg-1 (group T,n=10 ). In condition that the level of PetCO2 was kept in the normal range by a ventilator, peak, mean and end-diastolic blood flow velocity(Vp, Vm, and Vd) of middle cerebral artery(MCA) were measured by the transcranial Doppler sonography at 5 mins before and 10 mins after the administration of propofol or thiopental, meanwhile the mean artery pressure (MAP) was monitored. The values of the pulsatile index (PI) and resistance index(RI) of MCA were given by the following equations: PI=(Vp-Vd)/Vm and RI =(Vp-Vd )/VP. The results showed that following the administration,the levels of MAP,Vm,Vp,Vd and PI significantly decreased separately by 13%, 24%, 31%, 20% and 29% in group P (P<0. 01 ) and by 9.7%, 13%,22%,21% and 14% in group T (P<0.01),and the value of RI was markedly reduced by 26% (P<0. 01) but remined stable in group T. There were not statistical differences in the above parameters apart from RI between two groups. Therefore,it is considered that the effects of propofol on cerebral blood flow may be similar to those of thiopental.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
1995年第9期397-399,共3页
Chinese Journal of Anesthesiology
