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阿法沙龙持续输注在神经麻醉中的应用。脑血流量、脑代谢、脑电图及血浆阿法沙龙浓度的变化

Use of a continuous infusion of althesin in neuroanaesthesia. Changes in cerebral blood flow, cerebral metabolism, the EEG and plasma alphaxalone concentration.

作者信息

Bendtsen A, Kruse A, Madsen J B, Astrup J, Rosenørn J, Blatt-Lyon B, Cold G E

出版信息

Br J Anaesth. 1985 Apr;57(4):369-74. doi: 10.1093/bja/57.4.369.

Abstract

Ten patients with small supratentorial tumours were studied during craniotomy. Cerebral blood flow (CBF) was measured in the contralateral hemisphere by a modification of the Kety and Schmidt technique using xenon-133 i.v. With an Althesin infusion rate of 0.2 ml kg-1 h-1, CBF was 24.4 +/- 5.4 ml min-1/100 g and CMRO2 1.87 +/- 0.44 ml min-1/100 g at PaCO2 4.1 +/- 0.7 kPa (mean +/- SD). During constant infusion rates of Althesin, steady values of CMRO2 were obtained, while an increase in infusion rate of 150% was associated with an increase in plasma alphaxalone concentration, a decrease in CMRO2 and a tendency of further EEG suppression. However, great inter- and intraindividual variations were present, and correlations between CMRO2, EEG activity and plasma alphaxalone concentration were weak.

摘要

对10例幕上小肿瘤患者在开颅手术期间进行了研究。采用改良的Kety和Schmidt技术,通过静脉注射氙-133,对侧半球的脑血流量(CBF)进行了测量。在阿法沙龙输注速率为0.2 ml·kg⁻¹·h⁻¹时,在动脉二氧化碳分压(PaCO₂)为4.1±0.7 kPa(均值±标准差)的情况下,CBF为24.4±5.4 ml·min⁻¹/100 g,脑氧代谢率(CMRO₂)为1.87±0.44 ml·min⁻¹/100 g。在阿法沙龙持续输注速率期间,获得了稳定的CMRO₂值,但输注速率增加150%与血浆阿法诺龙浓度升高、CMRO₂降低以及脑电图进一步抑制的趋势相关。然而,个体间和个体内存在很大差异,CMRO₂、脑电图活动和血浆阿法诺龙浓度之间的相关性较弱。

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