异丙酚对颅脑外伤手术病人脑脊液压力的影响

目的:观察异丙酚在颅脑外伤手术中对脑脊液压力(CSFP)、脑灌注压(CPP)、平均动脉压(MAP)和心率(HR)的影响。方法:30例ASAⅡ-Ⅳ级的颅脑外伤病人行开颅血肿清除术,足背动脉穿刺测MAP,L3-4蛛网膜下腔穿刺置管测CSFP。持续监测并记录麻醉诱导前、静脉注射芬太尼和咪畦安定后、静脉注射异丙酚后2分钟与5分钟时的MAP、HR、SpO2、PERCO2、CSFP、CPP。结果:CSPP在静脉注射异丙酚后2分钟较麻醉诱导前显著下降(P<0.05),5分钟时下降更为显著(P<0.01),10分钟时仍有显著下降。CPP在静注异丙酚后也有显著下降(P<0.01和P<0.05)。MAP在静脉注射异丙酚后2分钟、5分钟较麻醉诱导前显著下降(P<0.01)。HR较麻醉前仅有轻度降低。结论:异丙酚能降低CSFP、CPP和MAP,抑制插管反应,是颅脑手术麻醉的较好选择。

Effect of propofol on cerebrospinal fluid pressure during craniocerebral trauma operations

Objective: To investigate the effects of propofol of cerebrospinal fluid pressure(CSFP), cerebral perfusion pressure(CPP), mean arterial pressure(MAP) and heart rate(HR) on craniocerebral trauma operations. Methods: In 30 ASA gradeI-II craniocerebral trauma patients, a dorsal artery of foot catheter and a subarachanoid catheter were placed respectively prior to induction of anesthesia. CSFP, CPP, MAP and HR were monitored before induction, after intravenous Fentanyl and Midazolam, at 2 min and 5 min after intravenous propofol. Results: Compared with the preanesthetic baseline data, CSFP, CPP and MAP decreased significantly after intravenous propofol. No significant change in HR was found . Conclusion: After intravenous propofol, CSFP, CPP and MAP decreased significantly and intubation sponse was also abated. Prpofol can be a good choice in the anesthesia management of patients undergoing intracranial operations.