Lam A M
Department of Anesthesiology and Neurosurgery, University of Washington School of Medicine Seattle, Washington.
Agressologie. 1990 Jun;31(6):357-9.
Induced hypotension is frequently used during cerebral aneurysm dissection and clipping to reduce the risk of rupture. The ideal hypotensive agent does not exist and many drugs are currently used for the purpose of inducing hypotension. When used correctly serious complications are rare. These complications are either related to (1) the physiological effects of hypotension on the vital organs, namely, the brain, the heart, the lungs, the liver and the kidneys, or (2) the pharmacology of the respective hypotensive agent used which currently include the direct vasodilators-sodium nitroprusside and nitroglycerin; inhalation agents--isoflurane, enflurane and halothane; ganglionic blocker--trimethaphan; alpha/beta blockers- labetalol, esmolol; calcium channel blockers; and the experimental compound adenosine. Familiarity with both the physiology and pharmacology of induced hypotension will reduce the risk of complications of this useful technique.
在脑动脉瘤解剖和夹闭手术中，经常采用诱导性低血压来降低破裂风险。理想的降压药物并不存在，目前有许多药物用于诱导低血压。如果使用得当，严重并发症很少见。这些并发症要么与（1）低血压对重要器官（即脑、心、肺、肝和肾）的生理影响有关，要么与（2）所使用的各种降压药物的药理学有关，目前这些药物包括直接血管扩张剂——硝普钠和硝酸甘油；吸入剂——异氟烷、恩氟烷和氟烷；神经节阻滞剂——三甲噻方；α/β阻滞剂——拉贝洛尔、艾司洛尔；钙通道阻滞剂；以及实验性化合物腺苷。熟悉诱导性低血压的生理学和药理学将降低这种有用技术的并发症风险。
