Department of Anesthesia, Rigshospitalet 2041, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
Neurocrit Care. 2010 Feb;12(1):17-23. doi: 10.1007/s12028-009-9313-x.
Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (S(c)O(2)) following anesthesia-induced hypotension.
Following induction of anesthesia by fentanyl (0.15 mg kg(-1)) and propofol (2.0 mg kg(-1)), 13 patients received phenylephrine (0.1 mg iv) and 12 patients received ephedrine (10 mg iv) to restore mean arterial pressure (MAP). Heart rate (HR), MAP, stroke volume (SV), cardiac output (CO), and frontal lobe oxygenation (S(c)O(2)) were registered.
Induction of anesthesia was followed by a decrease in MAP, HR, SV, and CO concomitant with an elevation in S(c)O(2). After administration of phenylephrine, MAP increased (51 +/- 12 to 81 +/- 13 mmHg; P < 0.001; mean +/- SD). However, a 14% (from 70 +/- 8% to 60 +/- 7%) reduction in S(c)O(2) (P < 0.05) followed with no change in CO (3.7 +/- 1.1 to 3.4 +/- 0.9 l min(-1)). The administration of ephedrine led to a similar increase in MAP (53 +/- 9 to 79 +/- 8 mmHg; P < 0.001), restored CO (3.2 +/- 1.2 to 5.0 +/- 1.3 l min(-1)), and preserved S(c)O(2).
The utilization of phenylephrine to correct hypotension induced by anesthesia has a negative impact on S(c)O(2) while ephedrine maintains frontal lobe oxygenation potentially related to an increase in CO.
血管加压药用于纠正麻醉诱导性低血压。我们描述了麻醉诱导性低血压后，去氧肾上腺素和麻黄碱对额叶氧合（S(c)O(2)）的影响。
在芬太尼（0.15mg/kg）和异丙酚（2.0mg/kg）诱导麻醉后，13 名患者接受去氧肾上腺素（0.1mg 静脉注射），12 名患者接受麻黄碱（10mg 静脉注射）以恢复平均动脉压（MAP）。记录心率（HR）、MAP、每搏量（SV）、心输出量（CO）和额叶氧合（S(c)O(2)）。
麻醉诱导后 MAP、HR、SV 和 CO 降低，同时 S(c)O(2)升高。去氧肾上腺素给药后，MAP 升高（51±12 至 81±13mmHg；P<0.001；均值±SD）。然而，S(c)O(2)下降 14%（从 70±8%降至 60±7%）（P<0.05），CO 无变化（3.7±1.1 至 3.4±0.9l/min）。麻黄碱给药后，MAP 升高相似（53±9 至 79±8mmHg；P<0.001），CO 恢复（3.2±1.2 至 5.0±1.3l/min），S(c)O(2)得到维持。
用去氧肾上腺素纠正麻醉诱导性低血压会对 S(c)O(2)产生负面影响，而麻黄碱维持额叶氧合，可能与 CO 增加有关。
