Olsen K S, Henriksen L, Dige-Petersen H, Chraemmer-Jørgensen B, Rosenørn J
Department of Anaesthesiology, Glostrup Hospital, University of Copenhagen, Denmark.
Br J Anaesth. 1992 Sep;69(3):263-8. doi: 10.1093/bja/69.3.263.
We have studied the effect of ketanserin on cerebral blood flow (CBF), cerebral oxygen metabolism (CMRO2) and cerebrovascular carbon dioxide reactivity in 19 adult patients undergoing lumbar disc operation--10 during midazolam-fentanyl anaesthesia (group A) and nine during isoflurane anaesthesia (group B). Measurements were made in each patient whilst awake, during anaesthesia, during anaesthesia with ketanserin and during anaesthesia with ketanserin and hyperventilation. CBF was measured by the i.v. xenon-133 technique. CMRO2 was calculated as the product of CBF and the cerebral arterio-venous oxygen content difference. In the awake state, CBF was 52 and 51 ml/100 g min-1 and CMRO2 3.8 and 3.5 ml/100 g min-1 in groups A and B, respectively. After induction of anaesthesia, CBF decreased 37% in group A and 22% in group B (P < 0.05); CMRO2 decreased 26% in group A and 51% in group B (P < 0.05). Adding ketanserin did not change CBF or CMRO2 in either group. The carbon dioxide reactivity of the cerebral vessels during anaesthesia with ketanserin was 15.4% kPa-1 in group A and 24% kPa-1 in group B. We concluded that ketanserin, in a clinically recommended dose, administered during midazolam-fentanyl or isoflurane anaesthesia had no effect on global CBF, CMRO2 or the relationship between the two factors. Cerebrovascular carbon dioxide reactivity was preserved.
我们研究了酮色林对19例接受腰椎间盘手术的成年患者脑血流量（CBF）、脑氧代谢（CMRO2）和脑血管二氧化碳反应性的影响，其中10例在咪达唑仑 - 芬太尼麻醉期间（A组），9例在异氟烷麻醉期间（B组）。在每位患者清醒时、麻醉期间、使用酮色林麻醉期间以及使用酮色林并过度通气麻醉期间进行测量。CBF通过静脉注射氙 - 133技术测量。CMRO2计算为CBF与脑动静脉氧含量差的乘积。在清醒状态下，A组和B组的CBF分别为52和51 ml/100 g·min-1，CMRO2分别为3.8和3.5 ml/100 g·min-1。麻醉诱导后，A组CBF下降37%，B组下降22%（P<0.05）；A组CMRO2下降26%，B组下降51%（P<0.05）。添加酮色林后两组的CBF或CMRO2均未改变。使用酮色林麻醉期间脑血管的二氧化碳反应性在A组为15.4%kPa-1，在B组为24%kPa-1。我们得出结论，在咪达唑仑 - 芬太尼或异氟烷麻醉期间给予临床推荐剂量的酮色林对整体CBF、CMRO2或这两个因素之间的关系没有影响。脑血管二氧化碳反应性得以保留。
