氧化亚氮对七氟醚麻醉儿童脑血流速度的影响。

The effect of nitrous oxide on cerebral blood flow velocity in children anaesthetised with sevoflurane.

作者信息

Rowney D A, Fairgrieve R, Bissonnette B

机构信息

Consultant in Paediatric Anaesthesia, Royal Hospital for Sick Children, Sciennes Road, Edinburgh EH9 1LF, UK.

出版信息

Anaesthesia. 2004 Jan;59(1):10-4. doi: 10.1111/j.1365-2044.2004.03458.x.

DOI:10.1111/j.1365-2044.2004.03458.x

PMID:14687092

Abstract

To determine the effects of nitrous oxide on middle cerebral artery blood flow velocity (CBFV) during sevoflurane anaesthesia in children, CBFV was measured using transcranial Doppler sonography in 16 ASA I or II children. Anaesthesia consisted of 1.0 MAC sevoflurane in 30% oxygen with intermittent positive pressure ventilation maintaining FEco2 at 38 mmHg (5.0 kPa) and a caudal epidural block using 0.25% bupivacaine 1.0 ml.kg-1. The remainder of the inspired gas was varied in one of two sequences either air/nitrous oxide/air or nitrous oxide/air/nitrous oxide. The results showed that CBFV decreased when nitrous oxide was replaced by air (p = 0.03) and returned to its initial value when nitrous oxide was reintroduced. CBFV increased when air was replaced by nitrous oxide (p = 0.04) and returned to its initial value when air was reintroduced. Mean heart rate and blood pressure remained constant. We conclude that nitrous oxide increases cerebral blood flow velocity in healthy children anaesthetised with 1.0 MAC sevoflurane.

摘要

为确定氧化亚氮对小儿七氟醚麻醉期间大脑中动脉血流速度（CBFV）的影响，采用经颅多普勒超声对16例美国麻醉医师协会（ASA）分级为I或II级的小儿进行CBFV测量。麻醉方法为：吸入含30%氧气的1.0最低肺泡有效浓度（MAC）七氟醚，采用间歇正压通气使呼气末二氧化碳分压（FEco2）维持在38 mmHg（5.0 kPa），并使用0.25%布比卡因1.0 ml.kg-1进行骶管硬膜外阻滞。吸入气体的其余部分按两种顺序之一变化，即空气/氧化亚氮/空气或氧化亚氮/空气/氧化亚氮。结果显示，当氧化亚氮被空气取代时，CBFV降低（p = 0.03），当再次引入氧化亚氮时，CBFV恢复到初始值。当空气被氧化亚氮取代时，CBFV增加（p = 0.04），当再次引入空气时，CBFV恢复到初始值。平均心率和血压保持恒定。我们得出结论，氧化亚氮可增加接受1.0 MAC七氟醚麻醉的健康小儿的脑血流速度。