艾司洛尔控制开颅手术苏醒期脑过度灌注的效果  

Evaluation of esmolol in controlling cerebral hyperemia during wakening from anesthesia in craniotomy patients

作　　者：杨笑宇[1] 周守静[1] 俞莹芳[1] 

机构地区：[1]复旦大学附属华山医院麻醉科,上海200040

出　　处：《上海医学》2009年第6期516-519,共4页Shanghai Medical Journal

摘　　要：目的通过监测脑血流速度、颈静脉球部血氧饱和度(SjvO2)、血压、心率(HR)和不良反应发生率等,综合评价艾司洛尔用于控制开颅手术苏醒期患者脑过度灌注的效果。方法选择择期在全身麻醉下行开颅肿瘤切除术的患者,随机分为艾司洛尔组(E组,20例)和对照组(C组,20例)。E组患者从拔管即刻起给予艾司洛尔0.6mg·kg-1.h-1静脉持续滴注15min;C组患者从拔管即刻起给予0.9%氯化钠溶液静脉持续滴注。分别监测两组患者术前、术后拔管即刻及拔管后15、30、45、60min时的大脑中动脉平均血流速度(MCAVm)、SjvO2、平均动脉压(MAP)及HR,并记录不良反应发生例数。结果E组术后15和30min的MCAVm、SjvO2及HR均显著低于C组(P值均<0.01),术后15min的MAP显著低于C组(P<0.05)。无一例患者发生与艾司洛尔相关的药物不良反应。结论艾司洛尔是控制术后脑过度灌注的理想药物。Objective To evaluate the effect of esmolol in controlling the cerebral hyperemia during wakening from anesthesia in craniotomy patients by monitoring the cerebral blood flow velocity, blood oxygen saturation of jugular vein bulb （SjvO2）, blood pressure, heart rate （HR）, and side effect frequency, etc. Methods A total of 40 patients undergoing craniotomy were randomized into esmolol group （group E, n = 20） and control group （group C, n = 20）. Esmolol （0.6 mg · kg^-1· h^-1） was infused via extubation until 15 min later in group E, and a saline placebo was infused in group C. The mean velocity of middle cerebral artery （MCA Vm）, SjvO2, mean arterial pressure （MAP） and HR were recorded before anesthesia, at tracheal extubation, at 15, 30, 45, and 60 min after extubation in both groups. The side effect was observed. Results MCA Vm, SjvO2, MAP and HR in group E were significantly lower than those in group C within 30 min after extubation （P〈0. 05）. No esmolol-related side effect was observed during the study. Conclusion Esmolol is an effective drug to control cerebral hyperemia during wakening from anesthesia in craniotomy patients.

关 键 词：艾司洛尔 开颅手术 脑过度灌注 大脑中动脉平均血流速度 麻醉苏醒期 

分 类 号：R614[医药卫生—麻醉学]