Nagata Shun-ichi, Kazekawa Kiyoshi, Aikawa Hiroshi, Tsutsumi Masanori, Kodama Tomonobu, Iko Minoru, Nii Kohei, Matsubara Shuko, Go Yoshinori, Tanaka Akira
Department of Neurosurgery, Fukuoka University Chikushi Hospital, 377-1 Zokumyoin, Chikushino 818-8502, Japan.
Radiat Med. 2005 Sep;23(6):427-31.
The purpose of our study was to investigate the frequency of hemodynamic instability in patients undergoing carotid artery stenting (CAS) under general anesthesia using sevoflurane and nitrous oxide in oxygen.
A total of 97 consecutive CAS procedures were performed in 84 patients under sevoflurane anesthesia. The following hemodynamic variables were assessed: degree of systolic blood pressure change (deltaSBP) during CAS, hypotension, and bradycardia during and after CAS.
During CAS, hypotension occurred in 43% of the patients, and bradycardia occurred in 14%. There was individual variation in the deltaSBP during CAS. Systolic blood pressure (SBP) change >50 mmHg was not seen in this series. After CAS, hypotension occurred in 24%, and bradycardia occurred in 10%. Cerebral infarction occurred in three cases. The stroke rate was 3.1% in this series.
General anesthesia using sevoflurane and nitrous oxide in oxygen depressed barorecepter reflex sensitivity, induced hemodynamic stability under CAS, and may decrease the rate of occurrence of complications.
本研究的目的是调查在使用七氟醚和一氧化二氮-氧气进行全身麻醉的情况下，接受颈动脉支架置入术（CAS）的患者发生血流动力学不稳定的频率。
在七氟醚麻醉下，对84例患者连续进行了97例CAS手术。评估了以下血流动力学变量：CAS期间的收缩压变化程度（deltaSBP）、CAS期间及之后的低血压和心动过缓。
在CAS期间，43%的患者出现低血压，14%的患者出现心动过缓。CAS期间deltaSBP存在个体差异。本系列中未观察到收缩压（SBP）变化>50 mmHg的情况。CAS之后，24%的患者出现低血压，10%的患者出现心动过缓。发生了3例脑梗死。本系列的卒中发生率为3.1%。
使用七氟醚和一氧化二氮-氧气进行全身麻醉会降低压力感受器反射敏感性，在CAS期间诱导血流动力学稳定，并可能降低并发症的发生率。
