Werner C, Hoffman W E, Kochs E, Schulte am Esch J
Abteilung für Anästhesiologie, Universitäts-Krankenhaus Eppendorf, Hamburg.
Anaesthesist. 1992 Jan;41(1):34-8.
The intracranial hemodynamic and metabolic effects of 20 micrograms/kg sufentanil were studied in ten mongrel dogs. Anesthesia was maintained with 0.7 vol.% end-tidal isoflurane and 50% nitrous oxide in oxygen. Catheters were inserted into both femoral arteries and veins, the superior sagittal sinus, the left atrium, and the lateral cerebral ventricle for blood pressure measurement, arterial and sagittal sinus blood sampling, radioactive microsphere injections, and intracranial pressure (ICP) monitoring. Cardiac output (CO) was measured using an electromagnetic flow probe on the pulmonary artery. Following baseline measurements, sufentanil was injected and data were recorded at 5, 15, and 30 min. RESULTS. In group 1 (n = 5) blood pressure was not controlled, while in group 2 (n = 5) blood pressure was maintained at baseline level with a phenylephrine infusion. Arterial blood pressure decreased by 32% in response to sufentanil in group 1 and remained constant in group 2 according to the protocol. CO decreased by 40%-50% in both groups. Regional and global cerebral blood flow (CBF) decreased by 25%-40% with no difference between groups. The cerebral hemodynamic changes were associated with a decrease of 35%-40% in cerebral oxygen consumption. ICP did not change over time. DISCUSSION. These data are in contrast to studies in dogs, where sufentanil produced non-dose-dependent increases in CBF and ICP. Our results are more consistent with studies in humans and rats where administration of sufentanil was associated with either no change or decreases in cerebral hemodynamics, metabolism, and ICP. We conclude that in dogs with normal intracranial physiology sufentanil decreases regional and global CBF in response to a decrease in cerebral metabolic demand without significantly affecting ICP.
在十只杂种犬中研究了20微克/千克舒芬太尼的颅内血流动力学和代谢效应。采用0.7体积%的呼气末异氟烷和50%的氧化亚氮与氧气混合维持麻醉。将导管插入双侧股动脉和静脉、上矢状窦、左心房和侧脑室,用于测量血压、采集动脉和矢状窦血样、注射放射性微球以及监测颅内压(ICP)。使用置于肺动脉上的电磁流量探头测量心输出量(CO)。在进行基线测量后,注射舒芬太尼,并在5、15和30分钟记录数据。结果。在第1组(n = 5)中血压未得到控制,而在第2组(n = 5)中通过输注去氧肾上腺素将血压维持在基线水平。根据方案,第1组中舒芬太尼使动脉血压下降了32%,而第2组中动脉血压保持恒定。两组的CO均下降了40%-50%。局部和全脑血流量(CBF)下降了25%-40%,两组间无差异。脑血流动力学变化与脑氧耗量下降35%-40%相关。ICP未随时间变化。讨论。这些数据与在犬类中的研究结果相反,在犬类研究中舒芬太尼使CBF和ICP产生非剂量依赖性增加。我们的结果与在人类和大鼠中的研究更为一致,在这些研究中,给予舒芬太尼与脑血流动力学、代谢和ICP无变化或下降相关。我们得出结论,在颅内生理正常的犬类中,舒芬太尼可因脑代谢需求降低而使局部和全脑CBF下降,而不显著影响ICP。