摘要
目的 观察在控制性降压下的颅内动脉瘤夹闭术中罂粟碱浸泡术野对局部脑血流(rCBF)的影响。方法 2 4例颅内动脉瘤病人随机均分为异氟醚组 (A组 )和尼莫地平组 (B组 )。控制性降压期间 ,A组提高异氟醚吸入浓度至 1 4～ 1 6MAC ;B组尼莫地平 5～ 8μg/kg静注 ,继以 10～ 10 0 μg·kg 1·h 1的速度持续泵入 ,两组均维持MAP在 8 0～ 8 7kPa。动脉瘤夹闭后用罂粟碱浸泡术野 ,用激光多普勒血流仪连续监测rCBF的变化。结果 与动脉瘤夹闭前相比 ,夹闭后A组rCBF明显减少 (P <0 0 1) ,B组rCBF变化不大 (P >0 0 5 ) ;应用罂粟碱后 ,两组rCBF均明显高于用药前水平 (P <0 0 5 ) ,其中A组增加的幅度明显大于B组 (P <0 0 5 ) ;两组rCBF在用药后第 2 0～ 30分钟达到高峰 ,以后逐渐减少。结论 在颅内动脉瘤夹闭术中 ,罂粟碱浸泡术野可增加rCBF ;和异氟醚比较 。
Objective To observe the effects of local application of papaverine on regional cerebral blood flow (rCBF) in patients undergoing intracranial aneurysm surgery.Methods Twenty-four patients, scheduled for intracranial aneurysm surgery, were randomly divided into isoflurane (A,n=12) and nimodipine (B, n=12) groups.MAP was maintained at 8.0-8.7 kPa by 1.4-1.6 MAC isoflurane inhalation in group A or by a bolus of nimodipine, followed by a continuous infusion of 10-100 μg·kg -1·h -1 in group B. After aneurysm was clipped, papaverine was applied to all major vessels in both groups. rCBF was continuously measured by laser Doppler flowmetry (LDF) during the procedure.Results After clipping aneurysm,rCBF was decreased significantly in group A compared with that before (P<0.01),which was not significantly changed in group B (P>0.05). After local application of papaverine, rCBF was significantly increased in both groups (P<0.05), but the increase was more in group A than that in group B (P<0.05). Conclusion Local application of papaverine can increase rCBF during intracranial aneurysm surgery.rCBF is more stable when hypotension is induced by nimodipine than that by isoflurane.
出处
《临床麻醉学杂志》
CAS
CSCD
2004年第2期75-77,共3页
Journal of Clinical Anesthesiology
关键词
罂粟碱
颅内动脉瘤
手术
脑血流
脑血管
Papaverine
Deliberate hypotension
Cerebral blood flow
Intracranial aneurysm
