Lundar T, Lindegaard K F, Refsum L, Rian R, Nornes H
Department of Neurosurgery, Rikshospitalet, University of Oslo, Norway.
Br J Anaesth. 1987 Oct;59(10):1208-13. doi: 10.1093/bja/59.10.1208.
Twelve hydrocephalic patients undergoing hydrodynamic studies and shunt procedures during general anaesthesia were subjected to short term observations of the cerebrovascular effects of isoflurane. Intraventricular pressure (IVP), arterial pressure (AP); cerebral perfusion pressure (CPP = AP-IVP), end-tidal PCO2, Cerebral Function Monitor (CFM) activity and middle cerebral artery (MCA) flow velocity were measured. Introduction of 1% isoflurane for a 10-min period did not cause significant changes in IVP or MCA flow velocity, but caused marked and significant reductions in arterial pressure and CPP, and increases in CFM activity. In five patients 2% isoflurane was administered for another 5 min before discontinuation of the isoflurane. This caused further significant reduction in arterial pressure and increased IVP in four of the five patients. The decrease in CPP was thus even greater than the reduction in arterial pressure and the CFM activity decreased in four out of five patients. The MCA flow velocity did not change significantly.
12名在全身麻醉下接受流体动力学研究和分流手术的脑积水患者接受了异氟烷脑血管效应的短期观察。测量了脑室内压（IVP）、动脉压（AP）、脑灌注压（CPP = AP - IVP）、呼气末二氧化碳分压、脑功能监测仪（CFM）活动和大脑中动脉（MCA）流速。引入1%异氟烷10分钟未引起IVP或MCA流速的显著变化，但导致动脉压和CPP显著降低，以及CFM活动增加。在5名患者中，在停用异氟烷前再给予2%异氟烷5分钟。这导致动脉压进一步显著降低，5名患者中有4名患者的IVP升高。因此，CPP的降低甚至大于动脉压的降低，5名患者中有4名患者的CFM活动降低。MCA流速没有显著变化。
