Schulte am Esch J, Thiemig I, Pfeifer G, Entzian W
Anaesthesist. 1979 Mar;28(3):136-41.
The influence of inhalation anaesthetics on intracranial pressure (ICP), arterial blood pressure and cerebral perfusion pressure (CPP) was investigated on 12 unconscious patients with head injury having an initial ICP of about 20 mm Hg. Halothane, enflurane and nitrous oxide induced a considerable rise of ICP during a 15 to 25 minute period of observation. The moderate fall in blood pressure caused by halothane and enflurane enhanced the reduction of the calculated CPP. Besides, a regular fall in blood pressure of about 16% was observed under the influence of nitrous oxide, subsequently reducing the CPP in some cases under 40 mm Hg. Inhalation anaesthetics, including nitrous oxide, should therefore not be used in patients with decreased intracranial compliance before the increased ICP is treated.
对12例初始颅内压约为20 mmHg的昏迷颅脑损伤患者,研究了吸入麻醉药对颅内压(ICP)、动脉血压和脑灌注压(CPP)的影响。在15至25分钟的观察期内,氟烷、恩氟烷和氧化亚氮使ICP显著升高。氟烷和恩氟烷引起的血压适度下降加剧了计算得出的CPP的降低。此外,在氧化亚氮的影响下观察到血压有规律地下降约16%,随后在某些情况下CPP降至40 mmHg以下。因此,在治疗升高的ICP之前,包括氧化亚氮在内的吸入麻醉药不应用于颅内顺应性降低的患者。