McPherson R W, Briar J E, Traystman R J
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205.
Anesthesiology. 1989 May;70(5):843-50. doi: 10.1097/00000542-198905000-00022.
Cerebral blood flow (CBF) responsiveness to alterations in arterial CO2 tensions (PaCO2) during 1.4% and 2.8% isoflurane anesthesia was assessed. Dogs were initially anesthetized with thiopental (12 mg/kg, iv bolus), their tracheae intubated, after which anesthesia was maintained with 1.4% isoflurane. In eight animals three levels of PaCO2 (25, 40, and 60 mmHg) were studied during 1.4% and 2.8% isoflurane. Mean arterial blood pressure, sagittal sinus pressure, and cerebrospinal fluid pressure were measured and CBF was determined using radiolabeled microspheres. Cerebral perfusion pressure (CPP) was maintained constant at approximately 80 mmHg by inflation of a balloon in the midthoracic aorta. CBF during normocapnia was 70 +/- 14 and 118 +/- 18 ml.min-1.100 g-1 with 1.4% and 2.8% isoflurane, respectively. As PaCO2 was decreased and increased, CBF decreased and increased to 42 +/- 7% and 185 +/- 16% of control, respectively, during 1.4% isoflurane. During 2.8% isoflurane, hypocapnia decreased CBF to 39 +/- 6% of control, but CBF did not increase with hypercapnia. In a second group of animals (n = 8), the effects of changes in CPP during hypercapnia with 1.4% and 2.8% isoflurane were assessed. Increasing CPP approximately 25 mmHg with both 1.4% and 2.8% isoflurane increased CBF but did not change CVR from control. With 1.4% isoflurane, the cerebral vasculature constricts with hypocapnia and dilates with hypercapnia, whereas with 2.8% isoflurane, vasoconstriction to hypocapnia is retained but vasodilation to hypercapnia is absent.(ABSTRACT TRUNCATED AT 250 WORDS)
评估了在1.4%和2.8%异氟烷麻醉期间脑血流量(CBF)对动脉二氧化碳分压(PaCO2)变化的反应性。犬最初用硫喷妥钠(12mg/kg,静脉推注)麻醉,气管插管,之后用1.4%异氟烷维持麻醉。在八只动物中,研究了1.4%和2.8%异氟烷麻醉期间三个水平的PaCO2(25、40和60mmHg)。测量平均动脉血压、矢状窦压力和脑脊液压力,并使用放射性标记微球测定CBF。通过在胸主动脉中部充气球将脑灌注压(CPP)维持在约80mmHg恒定。在正常碳酸血症时,1.4%和2.8%异氟烷麻醉下的CBF分别为70±14和118±18ml·min-1·100g-1。随着PaCO2降低和升高,在1.4%异氟烷麻醉期间,CBF分别降至对照值的42±7%和升至185±16%。在2.8%异氟烷麻醉期间,低碳酸血症使CBF降至对照值的39±6%,但高碳酸血症时CBF未增加。在第二组动物(n = 8)中,评估了1.4%和2.8%异氟烷麻醉下高碳酸血症期间CPP变化的影响。1.4%和2.8%异氟烷麻醉下将CPP升高约25mmHg均增加了CBF,但未改变与对照相比的脑血流阻力(CVR)。在1.4%异氟烷麻醉下,脑血管在低碳酸血症时收缩,在高碳酸血症时扩张,而在2.8%异氟烷麻醉下,对低碳酸血症的血管收缩保留,但对高碳酸血症的血管扩张不存在。(摘要截断于250字)