《中国康复理论与实践》

《中国康复理论与实践》 ›› 2004, Vol. 10 ›› Issue (07): 396-397.

• 专题 • 上一篇    下一篇

地氟烷麻醉对颅脑手术患者脑保护作用的研究

罗芳; 申颖; 王恩真; 王保国; 焦希平   

  1. 首都医科大学附属北京天坛医院麻醉科 北京市 100050
  • 收稿日期:2004-05-17 出版日期:2004-07-25 发布日期:2004-07-25

Cerebral protective effect of desflurane anesthesia during craniotomy

LUO Fang, SHEN Ying, WANG En-zhen, et al   

  1. Department of Anesthesiology, Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing 100050, China
  • Received:2004-05-17 Published:2004-07-25 Online:2004-07-25

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被引次数

5

摘要： 目的探讨不同浓度地氟烷吸入麻醉对颅脑手术患者术中的脑保护作用。方法幕上占位性病变择期行开颅手术患者22例,麻醉诱导后均以地氟烷吸入维持麻醉,调节地氟烷吸入浓度分别维持在0.7、1.0和1.3最低肺泡有效浓度(MAC)各30min后采集颈内静脉球部血行血气分析,术中连续监测平均动脉压(MAP)、心率(HR)和颈内静脉球压(JBP)。结果10及13MAC较0.7MAC时颈内静脉球血氧饱和度(SjO2)均升高(P<0.05及P<0.01),1.0及1.3MAC之间SjO2无显著性差异(P>0.05)。MAP呈剂量依赖性下降。HR呈剂量依赖性增加趋势。JBP无显著变化。结论颅脑手术中,1.0MAC地氟烷即可达循环平稳,不升高JBP,维持脑氧供需平衡,起到脑保护作用。

关键词: 地氟烷, 颅脑手术, 颈内静脉球血氧饱和度

Abstract: Objective To determine the cerebral protective effect of different concentrations of desflurane anesthesia during craniotomy.Methods Twenty two patients, scheduled for selective craniotomy for resections of supratentorial mass lesions, were anesthetized by inhalation of desflurane. When the concentrations of desflurane were maintained at 0.7,1.0 and 1.3 mean alveolar concentration (MAC) for 30 min during removing the tumor, venous blood samples which were drawn through internal jugular bulb were analyzed. Mean arterial pressure (MAP), heart rate (HR), and jugular bulb pressure (JBP) were recorded during the craniotomy.Results Jugular bulb oxygen saturation (SjO2) was significantly declined at 1.0 and 1.3 MAC compared with that at 0.7 MAC (P<0.05 and P<0.01 respectively). There was no significant changes in SjO2 between 1.0 and 1.3 MAC (P>0.05). MAP declined dose dependently, and decreased more significantly at 1.3 MAC (P<0.01).HR and JBP increased slightly with the raising concentration of desflurane but there were no significant changes at any MAC of desflurane (P>0.05).Conclusion Desflurane anesthesia at 1.0 MAC shows cerebral protection effect during craniotomy with stable hemodynamics and improved cerebral oxygen supply and demand.

Key words: desflurane, craniotomy, jugular bulb oxygen saturation