Goddard-Finegold J, Donley D K, Adham B I, Michael L H
Dept of Pediatrics, Baylor College of Medicine, Houston, TX 77030.
Pediatrics. 1990 Oct;86(4):501-8.
Phenobarbital sodium has been used in anticonvulsant concentrations (15 to 40 micrograms/mL serum) in premature newborns in attempts to prevent periventricular and intraventricular hemorrhages. Although its clinical usefulness in this regard is controversial, phenobarbital treatment has been shown to reduce periventricular and intraventricular hemorrhages after hypertensive insult in newborn beagles. In this study cerebral blood flow values in steady state and during phenylephrine-induced hypertension with and without phenobarbital pretreatment were measured in newborn beagles. At anticonvulsant dosage, phenobarbital sodium decreased mean arterial blood pressure transiently during steady state and significantly reduced total cerebral blood flow during phenylephrine-induced hypertension without reducing mean arterial blood pressure. This phenobarbital sodium effect on cerebral blood flow was not as great in the presence of acidosis, and the initial hypotensive effect of phenobarbital sodium was sustained for a longer period of time during acidosis. Phenobarbital sodium may reduce the incidence of hemorrhages in the newborn brain by providing protection against isolated hemodynamic stresses characterized by acute increases in cerebral blood flow, with or without increased mean arterial blood pressure.
苯巴比妥钠已被用于早产新生儿的抗惊厥浓度（血清浓度为15至40微克/毫升），试图预防脑室周围及脑室内出血。尽管其在这方面的临床实用性存在争议，但在新生比格犬中，苯巴比妥治疗已被证明可减少高血压损伤后的脑室周围及脑室内出血。在本研究中，对新生比格犬在稳态以及苯肾上腺素诱导的高血压期间（有无苯巴比妥预处理）的脑血流量值进行了测量。在抗惊厥剂量下，苯巴比妥钠在稳态时会使平均动脉血压短暂下降，在苯肾上腺素诱导的高血压期间显著降低总脑血流量，而不降低平均动脉血压。在酸中毒情况下，苯巴比妥钠对脑血流量的影响没那么大，且苯巴比妥钠的初始降压作用在酸中毒期间持续时间更长。苯巴比妥钠可能通过提供针对以脑血流量急性增加为特征的孤立血流动力学应激的保护作用，来降低新生儿脑内出血的发生率，无论平均动脉血压是否升高。
