异丙酚诱导、普鲁卡因静脉复合液维持麻醉对颅内压、脑灌注压的影响

１１例颅内压增高行硕内肿瘤切除术患者，用异丙酚２ｍｇ／ｋｇ诱导，普鲁卡因静脉复合液维持麻醉，按普鲁卡因１ｍｇ／ｋｇ／ｍｉｎ滴入。诱导前，后共３５ｍｉｎ，观察ＭＡＰ、ＩＣＰ、ＣＰＰ变化。结果发现：异丙酚可使ＩＣＰ迅速显著降低（Ｐ＜００１）；诱导开始到插管后，ＣＰＰ无显著变化（Ｐ＜０．０５），插管１０ｍｉｎ后有显著升高。结果认为：异丙酚可使高颅压患者ＩＣＰ迅速显著下降；普鲁卡因维持麻醉，可较好地维持循环功能，稳定，和维护脑的自身调节能力，对ＩＣＰ下降起到协同作用。

The effect of induction of propofol and maintenance with procaninebalanced anesthesia on intracranial pressure, maen blood pressure andcerebral perfusion pressure

Intracranial pressure (ICP), mean blood pressure (MDP)and cerebral perfusion pressure (CPP) were measured in 11 patients with intracranial hypertension scheduled for elective cranitomy with induction of propofol 2mg/kg and maintenance with procaine balanced anesthesia (procaine infusion rate 1mg/kg/min).Continued measurement of ICP,MBP were made from the induction till 35 minutes after incubation.The results show:ICP decreases significantly from 2 minutes of the induction till 35 minutes after the incubationP<0.01;CPP have no significant change during induction but significant increase 10 minutes after incubation.The induction of propofol 2mg/kg decreases ICF of patients with intracranial hypertension.Maintenance with procaine balanced anesthesia could keep a stable circulation and brain autoregulation.Another procaine also plays a role in long time decrease of ICP.