浅低温异丙酚复合异氟醚控制性降压用于颅脑手术的临床观察

目的　观察浅低温异丙酚复合异氟醚控制性降压用于颅脑手术的临床效果。方法　 2 0例患者经颈内静脉输入 0℃～ 4℃平衡液实施全身降温。在气管内吸入 1.5 %～ 2 .0 %异氟醚的基础上静注异丙酚控制性降压。结果　 12 0例患者术中共输入 0℃～ 4℃平衡液 12 0 0± 30 0 ml,降温 33.1± 0 .8℃ ;2在需要降压时 ,静注异丙酚30～ 40 mg·kg- 1· h- 1 ,4.5± 0 .5 min内达到所需控制性降压水平 ,继而按 4～ 6 m g·kg- 1· h- 1输入异丙酚可维持适宜的低血压水平 ,停用异丙酚 5 .5± 0 .5 min,血压可自动恢复到降压前水平。结论　浅低温异丙酚复合异氟醚控制性降压 ,方法简单 ,易于调节 ,脑保护作用明显。

Clinical observation of controlled hypotension with combination of isoflurane and propofol under light hypothermia for craniotomy

Objective To observe the clinical effect of controlled hypotension with isoflurane and propofol under light hypothemia for craniotomy．Methods Twenty patients were administered total body hypothermia with infusion 0℃～4℃ compound sodiumlactate through central venous access,and controlled hypotension with isoflurane inhalation （1．5％～2．0％） combined with propofol infusion．Results ①The patients were infused compound sodiumlactate 1 200±300 ml,hypothemia to 33．1±0．8℃;②When controlled hypotension was required the propofol infusion was 30～40 mg*kg－1*h－1,4．5±0．5 min and the mean aterial pressure（MAP） descended to 8～9．3 kPa．When decreasing the propofol to 4～6 mg*kg－1*h－1 MAP was maintained within this range．After withdrawal of propofol administration for 5．5±0．5 min MAP recovered．Conclusion Combination of isoflurane and propofol under light hypothemia is an effective and simple method to control hypotension and the effect is obvious in brain protection．