Lutz L J, Milde J H, Milde L N
Department of Anesthesia, Mayo Clinic, Rochester, Minnesota 55905.
Anesthesiology. 1991 Mar;74(3):504-7. doi: 10.1097/00000542-199103000-00019.
Arterial CO2 tension (PaCO2) is an important factor controlling cerebral blood flow (CBF) and cerebral vascular resistance (CVR) in animals and humans. The normal responsiveness of the cerebral vasculature to PaCO2 is approximately 2 ml.min-1.100 g-1.mmHg-1. This study examined the effect of desflurane, a new volatile anesthetic, on the responsiveness of the cerebral vasculature to changes in PaCO2. Mean arterial pressure (MAP), CBF, CVR, intracranial pressure (ICP), and cerebral metabolic rate for O2 (CMRO2) were measured in five dogs anesthetized with desflurane (0.5-1.5 MAC) at normocapnia (PaCO2 = 40 mmHg) and at two levels of hypocapnia (PaCO2 = approximately 30 and approximately 20 mmHg). Under desflurane anesthesia, similar changes in CBF and CVR occurred with hyperventilation at all MAC levels of desflurane. At 0.5 MAC, CBF decreased significantly, from 81 +/- 6 to 40 +/- 3 ml.min-1.100 g-1 (P less than 0.05, mean +/- SE) when PaCO2 was decreased from 40 to 24 mmHg; i.e., the CBF decreased approximately 2.6 ml.min-1.100 g-1.mmHg-1. At 1.0 MAC desflurane, CBF decreased significantly, from 79 +/- 10 to 43 +/- 5 ml.min-1.100 g-1 with hyperventilation (2.0 ml.min-1.100 g-1.mmHg-1); at 1.5 MAC desflurane, CBF decreased from 65 +/- 6 to 38 +/- 2 ml.min-1.100 g-1 with hyperventilation (1.6 ml.min-1.100 g-1.mmHg-1). Despite the significant decreases in CBF with hyperventilation, there was no significant change in ICP. Dose-dependent decreases in MAP were observed with increasing concentrations of desflurane but were not significantly affected by ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)
动脉血二氧化碳分压(PaCO2)是控制动物和人类脑血流量(CBF)及脑血管阻力(CVR)的一个重要因素。脑血管对PaCO2的正常反应性约为2 ml·min-1·100 g-1·mmHg-1。本研究检测了新型挥发性麻醉药地氟醚对脑血管对PaCO2变化的反应性的影响。在5只用地氟醚(0.5 - 1.5 MAC)麻醉的犬中,于正常碳酸血症(PaCO2 = 40 mmHg)及两种低碳酸血症水平(PaCO2 = 约30 mmHg和约20 mmHg)时测量平均动脉压(MAP)、CBF、CVR、颅内压(ICP)和脑氧代谢率(CMRO2)。在地氟醚麻醉下,在所有地氟醚MAC水平时,过度通气均使CBF和CVR发生类似变化。在0.5 MAC时,当PaCO2从40 mmHg降至24 mmHg时,CBF显著降低,从81±6降至40±3 ml·min-1·100 g-1(P < 0.05,均值±标准误);即CBF降低约2.6 ml·min-1·100 g-1·mmHg-1。在1.0 MAC地氟醚时,过度通气使CBF显著降低,从79±10降至43±5 ml·min-1·100 g-1(2.0 ml·min-1·100 g-1·mmHg-1);在1.5 MAC地氟醚时,过度通气使CBF从65±6降至38±2 ml·min-1·100 g-1(1.6 ml·min-1·100 g-1·mmHg-1)。尽管过度通气使CBF显著降低,但ICP无显著变化。随着地氟醚浓度增加,观察到MAP呈剂量依赖性降低,但通气对此无显著影响。(摘要截短于250词)