Bendtsen A O, Cold G E, Astrup J, Rosenørn J
Acta Anaesthesiol Scand. 1984 Oct;28(5):473-7. doi: 10.1111/j.1399-6576.1984.tb02101.x.
In this study we report our clinical experience with supplementary thiopental loading, based on 30 patients undergoing surgery for intracranial aneurysm after a recent episode of subarachnoid haemorrhage. As standard procedure we used pentobarbitone induction, pancuronium relaxation, endotracheal intubation, maintenance with halothane 0.5%, N2O 66% in oxygen, fentanyl, and moderate hypocapnia. A thiopental load of up to 20 mg X kg-1 was supplied while the aneurysm was approached. Satisfactory and well-controlled hypotension was obtained in five cases after thiopental alone, and after thiopental and sodium nitroprusside (SNP) (means +/- s.d.) 1.3 +/- 0.9 microgram X kg-1 X min-1 in the remaining 25 patients. No ECG sign of myocardial ischaemia was observed. One disadvantage was a prolonged recovery period, which in some cases necessitated controlled ventilation for some hours. We conclude that thiopental loading can be used safely as a supplement to neuroanaesthesia for aneurysm surgery.
在本研究中，我们报告了基于30例近期发生蛛网膜下腔出血后接受颅内动脉瘤手术患者的硫喷妥钠补充负荷给药的临床经验。作为标准操作，我们采用戊巴比妥诱导、泮库溴铵松弛、气管插管，并用0.5%氟烷、66%氧化亚氮加氧气、芬太尼维持麻醉，并适度降低二氧化碳分压。在接近动脉瘤时给予高达20mg/kg的硫喷妥钠负荷量。仅使用硫喷妥钠后，5例患者获得了满意且血压控制良好的低血压状态，其余25例患者在使用硫喷妥钠和硝普钠（SNP）后（均值±标准差）为1.3±0.9μg/kg/min获得满意且血压控制良好的低血压状态。未观察到心肌缺血的心电图迹象。一个缺点是恢复期延长，在某些情况下需要进行数小时的控制通气。我们得出结论，硫喷妥钠负荷给药可安全地用作动脉瘤手术神经麻醉的补充。
