Brüssel T, Van Aken H, Fitch W
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Westfälische Wilhelms-Universität Münster.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1992 Nov;27(7):414-20. doi: 10.1055/s-2007-1000325.
The results of two studies on the effects of halothane and isoflurane in increasing end-tidal concentrations (0.25; 0.5; 1.0vol%) on the cerebral metabolic rate for oxygen and the cerebral blood flow are compared. Both studies were performed on baboons using the same experimental model. Cerebral blood flow was determined from a washout curve after the intracarotid injection of 133xenon. Halothane and isoflurane led to a dose-dependent decrease of the cerebral metabolic rate for oxygen. Increasing concentrations of halothane caused a decrease of cerebral oxygen consumption from 3.4 +/- 0.8 (baseline) to 2.9 +/- 0.8 (0.25vol%), 2.7 +/- 0.7 (0.5vol%) and 2.4 +/- 0.4 mlO2 100 g-1min-1 at 1.0vol%. The administration of isoflurane reduced the cerebral oxygen consumption significantly from baseline 3.7 +/- 1.0 to 2.9 +/- 0.9 at 0.25vol%, 2.6 +/- 0.6 at 0.5vol% and 1.8 +/- 0.8 mlO2 100 g-1min-1 with 1.0vol%. A significant, dose-independent reduction of the cerebral blood flow from 55.8 +/- 8.0 to 46.3 +/- 10.2 (0.25%) to 44.6 +/- 9.5 (0.5vol%) and 44.5 +/- 10.2 ml 100 g-1min-1 (1.0vol%) was observed with halothane. However, a dose-dependent decrease in calculated cerebrovascular resistance was seen at 1.0vol% of halothane. If mean arterial pressure was kept within the normal limits of cerebrovascular autoregulation by the administration of angiotensin-II-amid during 1.0vol% of halothane a marked increase in cerebral blood flow above the baseline value was observed. The lacking increase in cerebral blood flow observed at 1.0vol% of halothane without blood pressure support appeared to be caused by the low cerebral perfusion pressure rather than by vasoconstriction.(ABSTRACT TRUNCATED AT 250 WORDS)
比较了两项关于氟烷和异氟烷在增加呼气末浓度(0.25%;0.5%;1.0%体积分数)时对脑氧代谢率和脑血流量影响的研究结果。两项研究均使用相同的实验模型在狒狒身上进行。脑血流量通过颈内动脉注射133氙后的洗脱曲线来测定。氟烷和异氟烷导致脑氧代谢率呈剂量依赖性降低。氟烷浓度增加导致脑氧消耗量从3.4±0.8(基线)降至2.9±0.8(0.25%体积分数)、2.7±0.7(0.5%体积分数),在1.0%体积分数时为2.4±0.4 mlO₂100g⁻¹min⁻¹。给予异氟烷可使脑氧消耗量从基线的3.7±1.0显著降低至0.25%体积分数时的2.9±0.9、0.5%体积分数时的2.6±0.6以及1.0%体积分数时的1.8±0.8 mlO₂100g⁻¹min⁻¹。观察到氟烷可使脑血流量从55.8±8.0显著降低至46.3±10.2(0.25%)、44.6±9.5(0.5%体积分数)和44.5±10.2 ml 100g⁻¹min⁻¹(1.0%体积分数),且与剂量无关。然而,在1.0%体积分数的氟烷时,计算出的脑血管阻力呈剂量依赖性降低。如果在1.0%体积分数的氟烷期间通过给予血管紧张素II酰胺将平均动脉压维持在脑血管自动调节的正常范围内,则会观察到脑血流量显著高于基线值。在没有血压支持的情况下,1.0%体积分数的氟烷时未观察到脑血流量增加,这似乎是由于脑灌注压低而非血管收缩所致。(摘要截取自250字)