Vajramuni G V, Umamaheswara Rao G S, Pillai S V
J. N. Medical College, Belgaum, India.
Neurol India. 2004 Mar;52(1):79-81.
Regional differences in vascular response to anesthetic agents in brain areas with and without tumors have not been investigated till now. The existence of such differences may influence the regional distribution of cerebral blood flow under anesthesia.
In 8 patients with frontotemporal gliomas, middle cerebral artery blood flow velocity (VMCA), pulsatality index (PI) and resistance index (RI) were determined in the normal and pathological cerebral hemispheres before and after stable nitrous oxide-halothane anesthesia.
During halothane anesthesia, there was an increase in VMCA both in the normal cerebral hemisphere (69 +/- 11 to 100 +/- 38 cm/s; P = 0.05) and the hemisphere with tumor (65 +/- 17 to 83 +/- 28 cm/s; P = 0.04). A significant decrease in the pulsatality index and the resistance index was also observed in both the hemispheres (P < 0.05). The percentage changes of VMCA, PI and RI in both the hemispheres after anesthesia were not significantly different.
In patients with cerebral tumors, nitrous oxide-halothane anesthesia causes comparable changes of cerebral blood flow velocities in the hemisphere with tumor and the normal hemisphere.
迄今为止,尚未对有肿瘤和无肿瘤脑区血管对麻醉剂的反应差异进行研究。这种差异的存在可能会影响麻醉状态下脑血流的区域分布。
对8例额颞叶胶质瘤患者,在稳定的氧化亚氮-氟烷麻醉前后,测定正常和病变脑半球的大脑中动脉血流速度(VMCA)、搏动指数(PI)和阻力指数(RI)。
在氟烷麻醉期间,正常脑半球(从69±11至100±38厘米/秒;P = 0.05)和有肿瘤的半球(从65±17至83±28厘米/秒;P = 0.04)的VMCA均增加。两个半球的搏动指数和阻力指数也均显著降低(P < 0.05)。麻醉后两个半球VMCA、PI和RI的百分比变化无显著差异。
对于脑肿瘤患者,氧化亚氮-氟烷麻醉会使有肿瘤的半球和正常半球的脑血流速度发生类似变化。