Lorenz Ingo H, Kolbitsch Christian, Hörmann Christoph, Luger T J, Schocke Michael, Eisner Wilhelm, Moser Patrizia L, Schubert Heinrich, Kremser Christian, Benzer Arnulf
Department of Anaesthesia and Intensive Care Medicine, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
Neuroimage. 2002 Oct;17(2):1056-64.
Remifentanil is increasingly used in the context of anesthesia, e.g., in patients presenting for MRI examinations, not only as an analgesic but also to replace nitrous oxide. Therefore, a comparative analysis of the effects of commonly used doses of remifentanil and of nitrous oxide on cerebral hemodynamics is warranted. The present study used contrast-enhanced magnetic resonance (MR) perfusion measurement to compare the effects of nitrous oxide (N(2)O/O(2) = 50%; n = 9) and remifentanil (0.1 microg/kg/min; n = 10) on regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), and regional mean transit time (rMTT) in spontaneously breathing human volunteers. Remifentanil increased rCBF above all in basal ganglia, whereas in supratentorial gray matter the increase in rCBF was equal or even more pronounced when using nitrous oxide. In contrast, nitrous oxide produced a greater increase in rCBV in gray-matter regions than did remifentanil. In summary, nitrous oxide increased rCBV in all gray-matter regions more than did remifentanil. However, the increase in rCBF, especially in basal ganglia, was typically less pronounced than during infusion of remifentanil.
瑞芬太尼在麻醉领域的应用日益广泛，例如在接受磁共振成像（MRI）检查的患者中，它不仅作为一种镇痛药，还用于替代氧化亚氮。因此，有必要对常用剂量的瑞芬太尼和氧化亚氮对脑血流动力学的影响进行比较分析。本研究采用对比增强磁共振（MR）灌注测量法，比较氧化亚氮（N₂O/O₂ = 50%；n = 9）和瑞芬太尼（0.1μg/kg/min；n = 10）对自主呼吸的人类志愿者局部脑血流量（rCBF）、局部脑血容量（rCBV）和局部平均通过时间（rMTT）的影响。瑞芬太尼主要使基底节区的rCBF增加，而在幕上灰质，使用氧化亚氮时rCBF的增加相同甚至更显著。相比之下，氧化亚氮使灰质区域的rCBV增加幅度大于瑞芬太尼。总之，氧化亚氮使所有灰质区域的rCBV增加幅度大于瑞芬太尼。然而，rCBF的增加，尤其是在基底节区，通常不如输注瑞芬太尼时明显。
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