Darby J M, Nemoto E M, Yonas H, Melick J
Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh School of Medicine, Pennsylvania.
J Cereb Blood Flow Metab. 1991 May;11(3):522-6. doi: 10.1038/jcbfm.1991.96.
Stable xenon (Xe)-enhanced computed tomography is a potentially valuable tool for high resolution, three-dimensional measurement of CBF in patients. However, reports that Xe causes cerebrovascular dilation and increases intracranial pressure (ICP) have tempered enthusiasm for its use. The effects of 5 min of 33% Xe inhalation on ICP (right and left hemispheres) were studied in eight fentanyl-anesthetized Rhesus monkeys after right-sided cortical freeze injury. ICP, CBF, and physiological variables were monitored for up to 6 h postinsult. The preinjury (control) right hemispheric ICP was 8 +/- 5 mm Hg (mean +/- SD) and left hemispheric ICP was 5 +/- 2 mm Hg. Postinjury observations were classified into low (less than 15 mm Hg) and high ICP (greater than or equal to 15 mm Hg) groups. Both right and left ICP values averaged 9 +/- 3 mm Hg in the low ICP group. In the high ICP group, the right ICP was 20 +/- 4 mm Hg and left ICP was 21 +/- 6 mm Hg. ICP was unchanged by Xe inhalation under control conditions as well as in both low and high ICP groups postinjury. Postinjury, the MABP decreased 10-15 mm Hg in the low ICP group and 10-17 mm Hg in the high ICP group 2-3 min after the start of Xe inhalation (p less than 0.05). These results show that 33% Xe inhalation does not increase ICP in fentanyl-anesthetized monkeys but could decrease MABP in stressed states, presumably because of the anesthetic effects of Xe.
稳定氙气(Xe)增强计算机断层扫描是一种对患者脑血流量进行高分辨率三维测量的潜在有价值工具。然而,有报道称Xe会导致脑血管扩张并升高颅内压(ICP),这减弱了人们对其使用的热情。在8只经芬太尼麻醉的恒河猴右侧皮质冷冻损伤后,研究了吸入33% Xe 5分钟对ICP(右半球和左半球)的影响。在损伤后长达6小时监测ICP、脑血流量(CBF)和生理变量。损伤前(对照)右半球ICP为8±5毫米汞柱(平均值±标准差),左半球ICP为5±2毫米汞柱。损伤后的观察结果分为低ICP组(低于15毫米汞柱)和高ICP组(大于或等于15毫米汞柱)。低ICP组的右半球和左半球ICP值平均为9±3毫米汞柱。在高ICP组中,右ICP为20±4毫米汞柱,左ICP为21±6毫米汞柱。在对照条件下以及损伤后的低ICP组和高ICP组中,吸入Xe均未改变ICP。损伤后,低ICP组在吸入Xe开始后2 - 3分钟平均动脉血压(MABP)下降10 - 15毫米汞柱,高ICP组下降10 - 17毫米汞柱(p<0.05)。这些结果表明,在经芬太尼麻醉的猴子中吸入33% Xe不会升高ICP,但在应激状态下可能会降低MABP,推测是由于Xe的麻醉作用。