Tsutsui T, Maekawa T, Goodchild C, Jones J G
Department of Anesthesiology, Yamaguchi University School of Medicine, Japan.
Br J Anaesth. 1995 Jun;74(6):686-90. doi: 10.1093/bja/74.6.686.
Local cerebral blood flow (CBF) during three types of profound hypotension were compared using the quantitative autoradiographic [14]-C iodo-antipyrine method. Rats were rendered hypotensive to a mean arterial pressure of 30 mm Hg for 30 min by haemorrhage, trimetaphan or nitroprusside during 0.8% halothane anaesthesia. During haemorrhagic hypotension, mean local CBF was reduced significantly in all except two pontine regions. This reduction in flow ranged from 83% to 41% compared with the normotensive control group, with the neocortex and telencephalon most affected. During trimetaphan-induced hypotension, local CBF was reduced to the same degree and in the same pattern as that during haemorrhagic hypotension. In contrast, during nitroprusside-induced hypotension, local CBF in many regions of the brain was well maintained (57-101%); although local CBF was significantly below control in all cortical and telencephalic regions, it was significantly greater in the majority of these regions than in the other two hypotensive groups. We conclude that local CBF was significantly reduced in the neocortex and telencephalon by hypotension of this degree induced by all three methods, but nitroprusside preserved local CBF significantly better than the other methods, in these, as in most other regions.
采用定量放射自显影[14]C-碘安替比林法,比较了三种深度低血压状态下的局部脑血流量(CBF)。在0.8%氟烷麻醉期间,通过出血、三甲噻方或硝普钠使大鼠平均动脉压降至30 mmHg并持续30分钟,造成低血压状态。在出血性低血压期间,除两个脑桥区域外,所有区域的平均局部CBF均显著降低。与正常血压对照组相比,血流量减少幅度为83%至41%,其中新皮质和端脑受影响最大。在三甲噻方诱导的低血压期间,局部CBF降低的程度和模式与出血性低血压期间相同。相比之下,在硝普钠诱导的低血压期间,脑内许多区域的局部CBF保持良好(57 - 101%);尽管所有皮质和端脑区域的局部CBF均显著低于对照组,但在这些区域中的大多数,其局部CBF显著高于其他两个低血压组。我们得出结论,所有这三种方法诱导的这种程度的低血压均使新皮质和端脑的局部CBF显著降低,但在这些区域以及大多数其他区域,硝普钠对局部CBF的保护作用明显优于其他方法。