摘要
目的观察瑞芬太尼用于颅脑手术控制性降压对血流动力学和脑氧代谢的影响。方法择期行颅脑手术患者30例,ASAⅠ或Ⅱ级,随机均分为瑞芬太尼组(R组)和硝普钠组(N组)。术中监测和记录手术前、降压前、达到目标血压0min(T0)、5min(T1)、10min(T2)、20min(T3)、30min(T4)及停止降压5min(T5)、10min(T6)、30min(T7)时的HR、MAP、CVP、PETCO2和SpO2,并抽取桡动脉、右颈内静脉球部血标本测血气,计算麻醉后、手术前、降压前、达到目标血压10min的颈内静脉球部血氧含量差(Da-jvO2)、脑氧代谢率(CERO2)、RPP。结果 R组各时点HR慢于N组(P<0.05)。R组和N组的Da-jvO2、CERO2在降压时均下降(P<0.05),但两组差异无统计学意义。结论瑞芬太尼用于颅脑手术控制性降压在改善脑氧代谢的同时不增快HR。
Objective To observe the effects of deliberate hypotension with remifentanil on hemodynamics and cerebral oxygen supply and consumption in craniocerebral operations.Methods Thirty ASA Ⅰ or Ⅱ patients undergoing elective craniocerebral operations were equally randomized into two groups to induce deliberate hypotension with remifentanil（R group）and sodium nitroprusside（N group）.HR,MAP,CVP,PETCO2 and SpO2 were monotored during operations.Blood samples were taken from radial artery and internal jugular bulb to determine cerebral arteriovenous oxygen differences（Da-jvO2）,cerebral oxygen extraction（CERO2）,and rate-pressure product（RPP）.Results HR was lower in R group cmpared with N group（P〈0.05）.Da-jvO2 and CERO2 decreased during deliberate hypotension in two groups（P〈0.05）,however there was no significant difference between the two groups.Conclusion Deliberate hypotension with remifentanil improves cerebral blood flow-metabolism coupling without increasing HR.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2011年第1期12-14,共3页
Journal of Clinical Anesthesiology
