Peters K R, Quisling R G, Gilmore R, Mickle P, Kuperus J H
Department of Radiology, University of Florida College of Medicine, Gainesville.
AJNR Am J Neuroradiol. 1993 Jan-Feb;14(1):171-4.
To assess its vascular effects and safety, we used sodium methohexital (Brevital)--an ultrashort-acting barbiturate--as the provocative intraarterial agent in a series of 30 patients with arteriovenous malformations at a 1% concentration and at doses of less than 5 mg per injection. Digital vascular imaging was performed just prior to and just after the injections.
No angiographic or clinical evidence of apparent vasospasm occurred in the trial population (66 vascular pedicle injections in 30 patients). When functional tissue was perfused with 1-6 mg of the 1% Brevital solution, evidence of altered neurologic status became immediately apparent, but cleared within 2 minutes in all cases. None of the patients experienced either prolongation of the induced clinical symptoms or seizures to suggest any adverse effects related to either crystallization of the Brevital or the effects of injecting an alkaline solution in the cerebral circulation.
Though the full effects of methohexital in the cerebral circulation remain to be elucidated, existing reports suggest it is a safe provocative agent for use prior to embolotherapy for brain arteriovenous malformations.
为评估其血管效应及安全性，我们使用甲己炔巴比妥钠（速眠安）——一种超短效巴比妥酸盐——作为激发性动脉内用药，对30例患有动静脉畸形的患者进行了一系列研究，浓度为1%，每次注射剂量小于5毫克。在注射前及注射后即刻进行数字血管成像。
在试验人群（30例患者共进行66次血管蒂注射）中，未出现血管造影或临床明显血管痉挛的证据。当用1%的速眠安溶液1 - 6毫克灌注功能组织时，神经状态改变的证据立即显现，但所有病例均在2分钟内恢复正常。没有患者出现诱发临床症状延长或癫痫发作，提示与速眠安结晶或在脑循环中注射碱性溶液的效应相关的任何不良反应。
尽管甲己炔巴比妥钠在脑循环中的全部效应仍有待阐明，但现有报告表明，它是脑动静脉畸形栓塞治疗前使用的一种安全的激发性药物。
