Moss E, Powell D, Gibson R M, McDowall D G
Br J Anaesth. 1978 Aug;50(8):779-84. doi: 10.1093/bja/50.8.779.
Ten patients presenting for carniotomy were studied. Each was anaesthetized with thiopentone or Althesin followed by tubocurarine and the lungs were hyperventilated with nitrous oxide in oxygen. Fentanyl 0.2 mg was administered i.v. and the intracranial pressure (i.c.p.) and mean arterial pressure were recorded continuously for 10 min. At the time of administration of fentanyl nine of the 10 patients were hypocapnic (PaCO2 less than 4 kPa). The changes in i.c.p. were small. Cerebral perfusion pressures less than 50 mm Hg were observed in two patients who had moderate hypotension before the drug was given. We conclude that fentanyl is a valuable agent in the hyperventilation technique in patients with intracranial space-occupying lesions, provided that hypotension is absent.
对10例接受开颅手术的患者进行了研究。每例患者先用硫喷妥钠或阿耳忒辛麻醉，随后用筒箭毒碱，并用氧化亚氮和氧气进行肺过度通气。静脉注射0.2毫克芬太尼，连续记录颅内压（i.c.p.）和平均动脉压10分钟。在注射芬太尼时，10例患者中有9例存在低碳酸血症（动脉血二氧化碳分压低于4kPa）。颅内压变化较小。在给药前有中度低血压的2例患者中观察到脑灌注压低于50mmHg。我们得出结论，对于颅内占位性病变患者，在没有低血压的情况下，芬太尼是过度通气技术中的一种有价值的药物。
