Schulte am Esch J, Thiemig I, Entzian W
Anaesthesist. 1980 Oct;29(10):525-9.
Intracranial pressure (ICP), arterial blood pressure (BP) and the calculated cerebral perfusion pressure (CPP) were investigated under standard conditions in 14 patients with severe brain injury. The influence of etomidate 0.3 mg/kg in comparison with thiopentone 6.0 mg/mg was evaluated both in patients with primarily elevated ICP (group I) and with an increase of ICP produced by nitrous oxide in oxygen (group II). In both groups of patients a marked ICP reduction (42%/26%) was produced by etomidate as well as by thiopentone. Whereas the reduction of CPP caused by thiopentone was enhanced by a moderate fall in BP, no influence on either BP or CPP was observed with etomidate. A regular fall in BP by about 10-15% was observed under nitrous oxide in oxygen alone, subsequently reducing the CPP by about 25%. These results emphasize the importance of the actions and interactions of different combinations of anesthetics in patients with acute brain injury in the prevention of further brain ischaemia. We believe that etomidate like thiopentone has brain protective properties in patients with cerebral hypoxia and must therefore be considered as an important therapeutic agent in such patients.
在标准条件下，对14例重型颅脑损伤患者的颅内压（ICP）、动脉血压（BP）及计算得出的脑灌注压（CPP）进行了研究。比较了依托咪酯0.3mg/kg与硫喷妥钠6.0mg/kg的效果，评估对象包括原发性ICP升高的患者（I组）以及因笑气吸入导致ICP升高的患者（II组）。在两组患者中，依托咪酯和硫喷妥钠均使ICP显著降低（分别为42%/26%）。硫喷妥钠导致的CPP降低因BP适度下降而加剧，而依托咪酯对BP和CPP均无影响。单独吸入笑气时，BP会规律性下降约10 - 15%，随后CPP降低约25%。这些结果强调了不同麻醉药组合的作用及相互作用在急性脑损伤患者预防进一步脑缺血中的重要性。我们认为，依托咪酯与硫喷妥钠一样，对脑缺氧患者具有脑保护特性，因此必须被视为这类患者的重要治疗药物。
