芬太尼、舒芬太尼和阿芬太尼对脑牵开器压力的影响。

Effects of fentanyl, sufentanil, and alfentanil on brain retractor pressure.

作者信息

Herrick I A, Gelb A W, Manninen P H, Reichman H, Lownie S

机构信息

Department of Anaesthesia, University of Western Ontario, University Hospital, London, Canada.

出版信息

Anesth Analg. 1991 Mar;72(3):359-63. doi: 10.1213/00000539-199103000-00013.

DOI:10.1213/00000539-199103000-00013

PMID:1825264

Abstract

Sufentanil and alfentanil have been reported to increase cerebral blood flow and intracranial pressure. Agents producing these effects may adversely affect the relationship between brain retractors and underlying cerebral tissues during craniotomy, potentially predisposing the patient to brain retractor injury. The effects of fentanyl, sufentanil, alfentanil, and a placebo (saline) on brain retractor pressure were therefore evaluated prospectively in 24 adults undergoing elective craniotomy. None of these narcotics significantly affected brain retractor pressure. Each significantly and similarly decreased arterial pressure and cerebral perfusion pressure. If these narcotics are administered in doses that avoid adverse hemodynamic changes that could compromise cerebral tissues indirectly, each of the narcotics studied appears safe for intraoperative administration once the cranium is open.

摘要

据报道，舒芬太尼和阿芬太尼可增加脑血流量和颅内压。产生这些效应的药物可能在开颅手术期间对脑牵开器与下方脑组织之间的关系产生不利影响，从而使患者有发生脑牵开器损伤的潜在风险。因此，对24例接受择期开颅手术的成年人进行了前瞻性评估，以观察芬太尼、舒芬太尼、阿芬太尼和一种安慰剂（生理盐水）对脑牵开器压力的影响。这些麻醉药均未对脑牵开器压力产生显著影响。每种药物均显著且相似地降低了动脉压和脑灌注压。如果以避免出现可能间接损害脑组织的不良血流动力学变化的剂量使用这些麻醉药，那么一旦颅骨打开，所研究的每种麻醉药在术中使用似乎都是安全的。