论文部分内容阅读
目的 观察地氟醚以不同MAC值维持麻醉期间对脑脊液压力 (CSFP)和大脑中动脉血流速率 (VmMCA)的影响。方法 6 0名颅内肿瘤病人 ,随机分为 2组 ,A组选用地氟醚维持麻醉 ,B组选用异氟醚维持麻醉。每组病人又按维持麻醉的不同MAC值分为三小组 :分组MAC值为 0 .5、0 .8和 1.1。通过蛛网膜下腔导管监测CSFP的变化 ,分别于麻醉前、诱导插管时观察记录 ,并于MAC值稳定于预定值开始 ,每 5分钟测量一次直至手术开始。使用经颅超声多普勒监测仪 (TCD)监测VmMCA ,并于麻醉前、吸入麻醉药给予前和麻醉维持 45分钟时测量记录VmMCA。结果 地氟醚1 1MAC组的CSFP逐步升高并达到 16 .90± 4.0 1mmHg ,与基础值相比显著性增高 (P <0 .0 1) ,其他两小组及异氟醚各组的CSFP与基础值相比无显著性差异 (P >0 .0 5 )。地氟醚 1 1MAC组的VmM CA于麻醉维持 45分钟时与基础值相比显著性增快 (P <0 .0 5 ) ,而其他两小组及异氟醚各组的VmMCA与基础值相比无显著性差异 (P >0 .0 5 )。地氟醚组麻醉维持MAC值与 45分钟时的CSFP与VmMCA呈直线正相关 ,(r=0 .5 2 ,P <0 .0 5 )。结论 地氟醚可引起剂量依赖性CSFP和VmM CA升高 ,颅内压正常的病人 0 .8MAC地氟醚维持麻醉安全、平稳
Objectives To investigate the effect of desflurane on the maintenance of cerebrospinal fluid pressure (CSFP) and middle cerebral artery blood flow velocity (VmMCA) at different MAC values. Methods Sixty patients with intracranial tumors were randomly divided into two groups. Group A was given desflurane to maintain anesthesia, while group B was given isoflurane to maintain anesthesia. Each group of patients was divided into three subgroups according to different MAC values for maintaining anesthesia: group MAC values were 0.5, 0.8, and 1.1. The changes of CSFP were monitored by subarachnoid catheterization. Before intubation induction and intubation, the changes of CSFP were observed and recorded. The MAC value was stabilized at a predetermined value and measured every 5 minutes until the operation began. VmMCA was monitored using a transcranial Doppler monitor (TCD) and VmMCA was recorded before anesthesia, before inhalation anesthesia, and at 45 minutes after anesthesia was maintained. RESULTS: The CSFP of desflurane 1 1MAC group increased gradually and reached 16.90 ± 4.0 1mmHg, which was significantly higher than the baseline value (P <0.01). The CSFP of the other two groups and isoflurane groups There was no significant difference between the baseline values (P> 0.05). Desflurane 1 1MAC group VmM CA significantly increased at 45 minutes of anesthesia compared with baseline (P <0.05), while VmMCA in the other two groups and isoflurane groups was significantly lower than baseline No significant difference (P> 0.05). Desflurane group anesthesia maintained MAC value and 45 minutes when the CSFP and VmMCA showed a positive linear correlation (r = 0.52, P <0.05). Conclusion Desflurane induced a dose-dependent increase in CSFP and VmM CA. In patients with normal intracranial pressure, 0.8 M desflurane maintained anesthesia safely and steadily