[异氟烷麻醉期间皮质脑血流对二氧化碳的反应及自动调节]

[Response to CO2 and autoregulation of cortical cerebral blood flow during isoflurane anesthesia].

作者信息

Kitaguchi K, Kuro M, Furuya H, Sumida T, Yamagishi N, Hirai K, Simomura T, Simokawa M, Okuda T

机构信息

Department of Anesthesiology, Nara Medical College, Kashihara.

出版信息

Masui. 1990 Dec;39(12):1607-12.

PMID:2129131

Abstract

Response to CO2 and autoregulation of cortical cerebral blood flow (CBF) during isoflurane anesthesia were studied in 10 patients undergoing neurosurgery. The patients were anesthetized with 0.5 to 1.2% end-tidal isoflurane and 66% nitrous oxide in oxygen. The CBF was measured by thermal diffusion using a flow probe with a Peltier stack. PaCO2 was controlled to produce hypocarbia, normocarbia and hypercarbia by changing tidal volume and respiratory rate. Arterial blood pressure was altered. Hypotension was achieved by intravenous infusion of trimetaphan and hypertension was induced by intravenous administration of metaraminol. During isoflurane anesthesia the response to CO2 of CBF was kept at PaCO2 between 27.8 and 53.9 mmHg. The following relationship was obtained. CBF = 2.54 x PaCO2-53.0, r = 0.59, n = 131 The autoregulation of CBF was evaluated in 7 patients, and in 2 patients, the autoregulation of CBF was abolished.

摘要

对10例接受神经外科手术的患者研究了异氟烷麻醉期间对二氧化碳的反应及大脑皮质脑血流量（CBF）的自动调节。患者用0.5%至1.2%的呼气末异氟烷和66%的一氧化二氮加氧气进行麻醉。使用带有珀耳帖堆的流量探头通过热扩散测量CBF。通过改变潮气量和呼吸频率将动脉血二氧化碳分压（PaCO2）控制在低碳酸血症、正常碳酸血症和高碳酸血症水平。改变动脉血压。通过静脉输注曲美芬实现低血压，通过静脉注射间羟胺诱导高血压。在异氟烷麻醉期间，CBF对二氧化碳的反应保持在PaCO2为27.8至53.9 mmHg之间。得到以下关系：CBF = 2.54×PaCO2 - 53.0，r = 0.59，n = 131。对7例患者评估了CBF的自动调节，2例患者的CBF自动调节被消除。