Van Aken H, Puchstein C, Anger C, Heinecke A, Lawin P
Anesth Analg. 1984 Apr;63(4):381-5.
Intracranial pressure (ICP) was measured during induced hypotension with increasing doses of adenosine triphosphate (1-5 mg X kg-1 X min-1 ATP) in dogs without (group I) and with (group II) intracranial hypertension. After administration of 1 mg X kg-1 X min-1 ATP, ICP increased significantly from 11 +/- 4 mm Hg to 14 +/- 5 mm Hg (mean +/- SEM) (P less than 0.05; group I) and from 27 +/- 2 mm Hg to 38 +/- 6 mm Hg (P less than 0.05; group II), while mean arterial pressure (MAP) decreased from 103 +/- 10 mm Hg to 86 +/- 6 mm Hg (P less than 0.05; group I) and from 110 +/- 11 mm Hg to 90 +/- 11 mm Hg (P less than 0.05; group II). In both groups a slow decrease of ICP after the initial increase occurred with further lowering of MAP, but ICP remained significantly above control values even with a dose of 5 mg X kg-1 X min-1 ATP (P less than 0.05). Ventricular volume-pressure response curves (VPR) before and during intravenous infusion of 3 mg X kg-1 X min-1 ATP were constructed to determine changes in intracranial compliance (ICC). In both groups I and II ATP decreased ICC. On the basis of these results it is recommended that in the presence of intracranial mass lesions ATP should not be given to induce arterial hypotension before the dura is opened.
在无颅内高压（I组）和有颅内高压（II组）的犬中，静脉输注递增剂量的三磷酸腺苷（1 - 5 mg·kg⁻¹·min⁻¹ATP）诱导低血压时测量颅内压（ICP）。给予1 mg·kg⁻¹·min⁻¹ATP后，I组ICP从11±4 mmHg显著升高至14±5 mmHg（均值±标准误）（P<0.05），II组从27±2 mmHg升高至38±6 mmHg（P<0.05），而平均动脉压（MAP）I组从103±10 mmHg降至86±6 mmHg（P<0.05），II组从110±11 mmHg降至90±11 mmHg（P<0.05）。两组在初始升高后，随着MAP进一步降低，ICP缓慢下降，但即使给予5 mg·kg⁻¹·min⁻¹ATP，ICP仍显著高于对照值（P<0.05）。构建静脉输注3 mg·kg⁻¹·min⁻¹ATP前后的脑室容积 - 压力反应曲线（VPR）以确定颅内顺应性（ICC）的变化。I组和II组中ATP均降低了ICC。基于这些结果，建议在存在颅内占位性病变时，在打开硬脑膜之前不应给予ATP诱导动脉低血压。
