Polushin Iu S, Gaĭdar B V, Shchegolev A V, Baranenko Iu M, Gaĭsin R R, Svistov D V
Anesteziol Reanimatol. 1995 Jul-Aug(4):41-4.
Cerebral bloodflow and central hemodynamics were studied during general anesthesia in patients with tumors of the posterior cranial fossa operated on in a sitting posture. A sitting posture during general anesthesia is conductive to a marked reduction of the stroke volume and linear velocity of the cerebral bloodflow, this creating a risk of cerebral tissue ischemia under conditions of intracranial hypertension and a hardly adequate short-term compensatory increase of the total vascular resistance and "paradoxical" increase of cerebrovascular tone. Since the neurogenous mechanisms of cerebral bloodflow autoregulation are disordered during anesthesia, one should admit that stabilization of central hemodynamics at all stages of anesthesia is a most important condition for optimizing brain tissue perfusion.
对采用坐位进行后颅窝肿瘤手术的患者在全身麻醉期间的脑血流量和中心血流动力学进行了研究。全身麻醉期间采用坐位有助于显著降低心搏量和脑血流线性速度,这在颅内高压情况下会造成脑组织缺血风险,且总血管阻力的短期代偿性增加几乎不足,脑血管张力出现“反常”增加。由于麻醉期间脑血流自动调节的神经源性机制紊乱,应当承认,在麻醉各阶段稳定中心血流动力学是优化脑组织灌注的最重要条件。