Artru A A
Department of Anesthesiology, University of Washington School of Medicine, Seattle 98195.
J Neurosurg Anesthesiol. 1993 Jul;5(3):178-86. doi: 10.1097/00008506-199307000-00008.
Intracranial pressure (ICP) has been shown to increase dramatically during desflurane anesthesia, possibly as a result in part of an increase in the rate of cerebrospinal fluid (CSF) formation (Vf) or a decrease in the rate of CSF reabsorption. To examine this phenomenon, I designed a study to measure Vf, resistance to reabsorption of CSF (Ra), brain tissue water content, and the electroencephalographic activity (EEG) during desflurane anesthesia in dogs. Vf and Ra were determined using ventriculocisternal perfusion of mock CSF labeled with blue dextran. EEG activity was determined using aperiodic analysis. At the end of the study, brain tissue water contents of gray and white matter were determined by dry/wet weight ratios. Eighteen dogs were allocated into three groups. Group 1 (n = 6) was examined at five experimental conditions during normocapnia; group 2 (n = 6) was examined at five experimental conditions during hypocapnia. The experimental conditions for groups 1 and 2 were (a) baseline (halothane 0.5-1.0% inspired plus thiopental 12 mg.kg-1 i.v. given over 15 min followed by i.v. infusion at 12 mg.kg-1 x h-1), (b) 0.5 MAC (3.5 +/- 0.1% expired) and (c) 1.0 MAC (7.0 +/- 0.1% expired) desflurane at normal CSF pressure, and (d) and (e) 0.5 and 1.0 MAC desflurane at increased CSF pressure (> 30 cm H2O). Group 3 (n = 6), the control group, was examined over the same time period as groups 1 and 2. In the control group, desflurane was not administered; instead, the baseline condition (i.e., halothane plus thiopental) was maintained throughout the study.(ABSTRACT TRUNCATED AT 250 WORDS)
研究表明,在地氟烷麻醉期间颅内压(ICP)会急剧升高,这可能部分是由于脑脊液(CSF)生成速率(Vf)增加或CSF重吸收速率降低所致。为研究此现象,我设计了一项研究,以测量犬在地氟烷麻醉期间的Vf、CSF重吸收阻力(Ra)、脑组织含水量和脑电图活动(EEG)。使用标记有蓝色葡聚糖的模拟CSF进行脑室池灌注来测定Vf和Ra。使用非周期性分析来测定EEG活动。在研究结束时,通过干/湿重比来测定灰质和白质的脑组织含水量。18只犬被分为三组。第1组(n = 6)在正常碳酸血症的五种实验条件下进行检查;第2组(n = 6)在低碳酸血症的五种实验条件下进行检查。第1组和第2组的实验条件为:(a)基线(吸入0.5 - 1.0%氟烷加静脉注射硫喷妥钠12 mg·kg-1,15分钟内给予,随后以12 mg·kg-1×h-1静脉输注),(b)0.5 MAC(呼出浓度3.5±0.1%)和(c)1.0 MAC(呼出浓度7.0±0.1%)地氟烷,CSF压力正常,以及(d)和(e)CSF压力升高(> 30 cm H2O)时的0.5和1.0 MAC地氟烷。第3组(n = 6)为对照组,在与第1组和第2组相同的时间段内进行检查。在对照组中,不给予地氟烷;相反,在整个研究过程中维持基线条件(即氟烷加硫喷妥钠)。(摘要截断于250字)