Xu Z, Ren H, Huang Y, Zhang X, Luo A, Ye T
Department of Anesthesiology, PUMC Hospital, CAMS, PUMC, Beijing 100730, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2000 Aug;22(4):360-3.
The clinical experiment was designed for observing the effects of deliberate hypotension at different level on cerebral blood flow and metabolism.
30 ASA Grade I-II patients were randomly allocated to one of three groups (each group n = 10). Hypotension was induced by sodium nitroprusside in group 1[mean arterial pressure (MAP) = 55 mmHg] and group 2 (MAP = 65 mmHg). Group 3 (control) was on normotension. The changes of cerebral blood flow during hypotension were estimated according to the variability of cerebral blood flow velocity (CBFV) in the middle cerebral artery(MCA), which was obtained through transcranial Doppler ultrasonography (TCD).
Hypotension caused a moderate decrease in CBFV, but no significant difference, in CBFV and oxygen saturation in internal jugular vein(SjO2), either among three groups or during the procedure.
It is safe for cerebral perfusion and metabolism with deliberate hypotension at MAP = 55 mmHg.
设计本临床试验以观察不同水平的控制性低血压对脑血流和代谢的影响。
30例美国麻醉医师协会（ASA）分级为I-II级的患者被随机分为三组之一（每组n = 10）。第1组[平均动脉压（MAP）= 55 mmHg]和第2组（MAP = 65 mmHg）通过硝普钠诱导低血压。第3组（对照组）维持正常血压。根据经颅多普勒超声（TCD）获得的大脑中动脉（MCA）的脑血流速度（CBFV）变化来评估低血压期间的脑血流变化。
低血压导致CBFV适度下降，但三组之间或手术过程中，CBFV和颈内静脉血氧饱和度（SjO2）均无显著差异。
MAP = 55 mmHg的控制性低血压对脑灌注和代谢是安全的。
