Fujii Y, Tanaka H, Tsuruoka S, Toyooka H, Amaha K
Department of Anesthesiology, Toride Kyodo General Hospital, Ibaraki, Japan.
Anesth Analg. 1994 Jan;78(1):80-3. doi: 10.1213/00000539-199401000-00014.
The effects of intraperitoneal CO2 insufflation on middle cerebral arterial blood flow velocity were evaluated in 10 patients undergoing laparoscopic cholecystectomy under general anesthesia with nitrous oxide, oxygen, and isoflurane. Blood flow velocity was measured using transcranial Doppler ultrasonography. During CO2 insufflation, Paco2 and the end-tidal CO2 concentration (PETCO2) increased significantly compared with the preinsufflation baseline value (P < 0.01) while ventilation was kept constant. Cerebral blood flow velocity also increased significantly in comparison with the baseline value (P < 0.01). These values still exceeded baseline values 10 min after deflation of the peritoneal cavity. A significant positive correlation was observed between blood flow velocity and Paco2 (P < 0.001). Our results suggest that intraperitoneal CO2 insufflation during laparoscopic cholecystectomy increases cerebral blood flow and that this is probably due to an increased Paco2.
在10例接受氧化亚氮、氧气和异氟烷全身麻醉下行腹腔镜胆囊切除术的患者中，评估了腹腔内注入二氧化碳对大脑中动脉血流速度的影响。使用经颅多普勒超声测量血流速度。在注入二氧化碳期间，与注入前基线值相比，动脉血二氧化碳分压（Paco2）和呼气末二氧化碳浓度（PETCO2）显著升高（P < 0.01），而通气保持恒定。与基线值相比，脑血流速度也显著增加（P < 0.01）。腹腔放气10分钟后，这些值仍超过基线值。血流速度与Paco2之间存在显著正相关（P < 0.001）。我们的结果表明，腹腔镜胆囊切除术期间腹腔内注入二氧化碳会增加脑血流量，这可能是由于Paco2升高所致。
