Scheller M S, Todd M M, Drummond J C
Anesthesiology. 1986 May;64(5):598-604. doi: 10.1097/00000542-198605000-00009.
The effects of halothane and isoflurane on regional cerebral blood flow (CBF) were studied in 18 New Zealand White rabbits anesthetized with nitrous oxide (N2O) and morphine sulfate (MS) at three different levels of PaCO2. CBF was measured using the hydrogen clearance technique. Monitored variables were intracranial pressure (ICP), central venous pressure, heart rate, mean arterial pressure, electroencephalogram, arterial blood gases, end-tidal (ET) volatile anesthetic, and ET CO2. Addition of 1 MAC halothane to the N2O/MS background anesthetic caused flow to increase significantly in all three regions studied (cortex, dorsal hippocampus, white matter) at all three levels of PaCO2 (low: 20-25 mmHg; normal: 35-40 mmHg; high: 50-55 mmHg). Addition of 1 MAC isoflurane to the background anesthetic caused CBF to decrease significantly in all regions during hypocapnia. During normocapnia, CBF was unchanged with the addition of 1 MAC isoflurane in all regions and during hypercapnia, CBF increased significantly only in the dorsal hippocampus following addition of 1 MAC isoflurane to the MS/N2O background anesthetic. Volatile anesthetic administration was associated with significant, although small, increases in ICP at all PaCO2 levels. We conclude that 1 MAC concentrations of halothane and isoflurane have opposite effects on CBF when added to a N2O/MS anesthetic during hypocapnia and that the effects of isoflurane on regional CBF are dependent on PaCO2 in rabbits under the anesthetic conditions of this experiment.
在18只使用氧化亚氮(N₂O)和硫酸吗啡(MS)麻醉的新西兰白兔中,于三种不同的动脉血二氧化碳分压(PaCO₂)水平下,研究了氟烷和异氟烷对局部脑血流量(CBF)的影响。采用氢清除技术测量CBF。监测的变量包括颅内压(ICP)、中心静脉压、心率、平均动脉压、脑电图、动脉血气、呼气末(ET)挥发性麻醉药和ET二氧化碳。在N₂O/MS基础麻醉中添加1个最低肺泡有效浓度(MAC)的氟烷,在所有三个PaCO₂水平(低:20 - 25 mmHg;正常:35 - 40 mmHg;高:50 - 55 mmHg)下,所研究的所有三个区域(皮层、背侧海马体、白质)的血流量均显著增加。在低碳酸血症期间,向基础麻醉中添加1个MAC的异氟烷会导致所有区域的CBF显著降低。在正常碳酸血症期间,添加1个MAC的异氟烷后所有区域的CBF均未改变,而在高碳酸血症期间,在MS/N₂O基础麻醉中添加1个MAC的异氟烷后,仅背侧海马体的CBF显著增加。在所有PaCO₂水平下,挥发性麻醉药的使用均与ICP显著(尽管增幅较小)升高有关。我们得出结论,在低碳酸血症期间,当添加到N₂O/MS麻醉中时,1个MAC浓度的氟烷和异氟烷对CBF有相反的影响,并且在本实验的麻醉条件下,异氟烷对局部CBF的影响取决于兔的PaCO₂。