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[丙泊酚(得普利麻)在神经外科患者麻醉诱导中的应用。II. 其对颅内压和脑灌注压的影响]

[The use of propofol (Diprivan) for inducing anesthesia in neurosurgical patients. II. Its effect on intracranial pressure and on cerebral perfusion pressure].

作者信息

Tseĭtlin A M, Lubnin A Iu, Baranov O A, Luk'ianov V I

出版信息

Anesteziol Reanimatol. 1998 Jul-Aug(4):39-43.

PMID:9770818
Abstract

Clinical study of the effect of propofol (diprivan) on intracranial and cerebral perfusion pressure (ICP and CPP, respectively) in 30 patients with neurosurgical diseases of the brain showed that propofol without narcotic analgesics did not block ICP increase in response to tracheal intubation. If it was combined with narcotic analgesics, the optimal combination was with pyritramide in a dose of 0.4 mg/kg, because this combination blocked ICP increase in response to laryngoscopy and tracheal intubation and did not appreciably decrease CPP. Propofol for decreasing acute intracranial hypertension (like bolus injection of thiopental) during surgery is unjustified, because during anesthesia, bolus injection of propofol just negligibly decreases ICP.

摘要

对30例患有脑部神经外科疾病的患者进行的丙泊酚(得普利麻)对颅内压和脑灌注压(分别为ICP和CPP)影响的临床研究表明,不含麻醉性镇痛药的丙泊酚并不能阻止因气管插管引起的ICP升高。如果将其与麻醉性镇痛药联合使用,最佳组合是与剂量为0.4mg/kg的吡拉西坦联合,因为这种组合可阻止因喉镜检查和气管插管引起的ICP升高,且不会明显降低CPP。在手术期间使用丙泊酚降低急性颅内高压(如大剂量注射硫喷妥钠)是不合理的,因为在麻醉期间,大剂量注射丙泊酚只会轻微降低ICP。

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