颈动脉支架置入术中全身麻醉下的血流动力学稳定性
Hemodynamic stability under general anesthesia in carotid artery stenting.
作者信息
Nagata Shun-ichi, Kazekawa Kiyoshi, Aikawa Hiroshi, Tsutsumi Masanori, Kodama Tomonobu, Iko Minoru, Nii Kohei, Matsubara Shuko, Go Yoshinori, Tanaka Akira
机构信息
Department of Neurosurgery, Fukuoka University Chikushi Hospital, 377-1 Zokumyoin, Chikushino 818-8502, Japan.
出版信息
Radiat Med. 2005 Sep;23(6):427-31.
PURPOSE
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.
METHODS
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.
RESULTS
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.
CONCLUSION
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.
目的
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。
方法
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。
结果
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%。
结论
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。
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