Pinaud M, Lelausque J N, Chetanneau A, Fauchoux N, Menegalli D, Souron R
Département d'Anesthésiologie, Hôtel-Dieu, Nantes.
Ann Fr Anesth Reanim. 1991;10(1):2-9. doi: 10.1016/s0750-7658(05)80264-3.
The effects of propofol on cerebral blood flow, intracranial pressure (ICP) and cerebral oxygen consumption (CMRO2) were assessed in ten severely head-injured patients undergoing surgery for limb fractures. The patients, aged between 15 and 40 years, were in deep coma, scored 6-7 on the Glasgow coma score. They were mechanically ventilated and sedated with 1 mg.h-1 phenoperidine. Anaesthesia was carried out with a 2 mg.kg-1 intravenous bolus of propofol, immediately followed by a 150 micrograms.kg-1.min-1 infusion, which lasted for a mean time of 41.4 +/- 7.3 min. Data were collected 5 min before any propofol was given, 15 min after the start of the infusion, and 15 min after its end. A radial artery cannula, a 7.5 Fr thermodilution flow-directed pulmonary arterial catheter, a cerebral intraventricular catheter and a catheter in the jugular venous bulb were used for this purpose. Carotid arterial injection of 133Xenon was used to determine regional cerebral blood flow (rCBF). Anaesthetic blood concentrations of propofol (3 to 5 micrograms.ml-1) were associated with a decrease in all the parameters studied: cerebral perfusion pressure, from 82 +/- 14 mmHg to 59 +/- 7 mmHg (p less than 0.001); rCBF, from 35 +/- 6 ml.100 g-1.min-1 to 26 +/- 5 ml.100 g-1.min-1 (p less than 0.01); ICP from 11.3 +/- 2.6 mmHg to 9.2 +/- 2.5 mmHg (p less than 0.001); CMRO2 from 1.63 +/- 0.38 mlO2 +/- 100 g-1.min-1 to 1.18 +/- 0.38 mlO2.100 g-1.min-1 (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
在10例因肢体骨折接受手术的重度颅脑损伤患者中，评估了丙泊酚对脑血流量、颅内压（ICP）和脑氧耗量（CMRO2）的影响。患者年龄在15至40岁之间，处于深度昏迷状态，格拉斯哥昏迷评分为6 - 7分。他们接受机械通气，并以1毫克·小时⁻¹的哌替啶进行镇静。麻醉采用2毫克·千克⁻¹的丙泊酚静脉推注，随后立即以150微克·千克⁻¹·分钟⁻¹的速度输注，平均持续时间为41.4±7.3分钟。在给予任何丙泊酚之前5分钟、输注开始后15分钟以及输注结束后15分钟收集数据。为此使用了桡动脉插管、7.5 Fr热稀释血流导向肺动脉导管、脑室内导管和颈静脉球导管。通过颈动脉注射¹³³氙来测定局部脑血流量（rCBF）。丙泊酚的麻醉血药浓度（3至5微克·毫升⁻¹）与所有研究参数的降低相关：脑灌注压从82±14毫米汞柱降至59±7毫米汞柱（p＜0.001）；rCBF从35±6毫升·100克⁻¹·分钟⁻¹降至26±5毫升·100克⁻¹·分钟⁻¹（p＜0.01）；ICP从11.3±2.6毫米汞柱降至9.2±2.5毫米汞柱（p＜0.001）；CMRO2从1.63±0.38毫升O₂·100克⁻¹·分钟⁻¹降至1.18±0.38毫升O₂·100克⁻¹·分钟⁻¹（p＜0.01）。（摘要截断于250字）
