Merlo F, Demo P, Lacquaniti L, Tricarico L, Faccin G, Irone M
II Servizio di Anestesia e Rianimazione, Stabilimento Ospedaliero S. Bortolo, ULSS 8, Vicenza.
Minerva Anestesiol. 1991 Jun;57(6):359-63.
Eleven patients with intracranial pressure (ICP) above 20 mmHg despite hyperventilation and neurosedation were treated with a bolus of propofol (1.5 mg/kg) i.v. At baseline and 1-2-5-10-15-30-45 minutes after propofol administration we recorded the values of PIC, systolic arterial pressure (SAP) and mean arterial pressure (MAP), heart rate (HR) and cerebral perfusion pressure (CPP), calculated as MAP less PIC. In the first ten minutes after propofol we observed a statistically significant (p less than 0.05) decrease of ICP and SAP. MAP decreased in the first five minutes only. Consequently HR increased at the same time. CPP decreased in the first two minutes after administration of the drug, but without statistical evidence. We conclude that propofol, in our opinion, can be used to treat intracranial hypertension but the hemodynamic effects in hypovolemic patients must be taken into consideration.
尽管进行了过度换气和神经镇静,但颅内压(ICP)仍高于20 mmHg的11例患者接受了静脉推注丙泊酚(1.5 mg/kg)治疗。在基线以及丙泊酚给药后1、2、5、10、15、30、45分钟,我们记录了脑灌注压(PIC)、收缩压(SAP)、平均动脉压(MAP)、心率(HR)和脑灌注压(CPP)的值,CPP通过MAP减去PIC计算得出。在丙泊酚给药后的前十分钟,我们观察到ICP和SAP有统计学意义的显著下降(p小于0.05)。MAP仅在最初五分钟下降。因此,心率同时增加。给药后两分钟内CPP下降,但无统计学依据。我们得出结论,我们认为丙泊酚可用于治疗颅内高压,但必须考虑其对低血容量患者的血流动力学影响。