异丙酚和普鲁卡因对颅内压及脑灌注压的影响  

Effect of propofol and procaine on intracranial pressure and cerebral perfusion pressure

作　　者：陈萍[1] 周泽军[1] 陈敦敏[1] 唐文渊[2] 王波[2] 朱继[2] 

机构地区：[1]重庆医科大学附属第一医院麻醉科,400016 [2]重庆医科大学附属第一医院神经外科,400016

出　　处：《中华麻醉学杂志》2000年第3期133-135,共3页Chinese Journal of Anesthesiology

摘　　要：目的　观察异丙酚、普鲁卡因对颅内压 (ICP)和脑灌注压 (CPP)的影响。方法　 2 5例脑肿瘤病人随机分成异丙酚组 (D组 )和普鲁卡因组 (P组 )。局麻下钻孔于颅骨及脑膜间安置SP -2 0 0 0型颅内压监护仪 ,连续监测ICP ,同时用Colin5 0 8连续监测MAP、HR及PETCO2。静注异丙酚2mg/kg后 ,输注异丙酚 10 0～ 15 0 μg·kg-1·min-1或普鲁卡因 1mg·kg-1·min-130min ,观察ICP、MAP及CPP的变化。结果　静注异丙酚 2mg/kg后 ,两组病人ICP、MAP及CPP较诱导前有显著性降低(P <0 0 5 ) ,两组间无明显差异 (P >0 0 5 )。D组病人维持期 ,ICP持续低于诱导前水平下降幅度18%～ 47% ,MAP、CPP回升至诱导前水平 ,维持稳定。P组病人ICP也低于诱导前水平 ,下降幅度15 %～ 30 % ,和D组间比较无显著差异 (P >0 0 5 )。插管后 2 0分钟 ,MAP、CPP及HR较诱导前和D组明显增加 (P <0 0 5 )。结论　异丙酚静脉麻醉更适宜神经外科手术。Objective To observe the effects of propofol intravenous anesthesia and procaine balanced anesthesia on intracranial pressure (ICP),mean arterial pressure (MAP)and cerebral perfusion pressure(CPP).Methods Twenty-five patients with brain tumor, scheduled for elective cranitomy,were randomly divided into two groups. Anesthesia was induced with propofol 2mg/kg in both groups ,and was maitained with infusion 0.2% propofol 100-150μg·kg -1·min -1 (D group, n=14). or infusion 2% procaine 1mg·kg -1·min -1 (P group, n=11). ICP,MAP and HR were monitored continuously.Results (1) ICP, MAP and CPP decreased significantly during induction in both groups(P<0.05). From intubation to 30 min of anesthesia, ICP remained lower than pre-induction level in both groups(P<0.05), without the significant differences between two group (P>0.05). MAP and CPP were kept stable in D group, but increased obviously 20 min after anesthesia in P group, there were significant differences between two groups (P<0.05). Conclusions Propofol intravenous anesthesia is more appropriated for the cranitomy in the patients with brain tumor.

关 键 词：颅内压 异丙酚 普鲁卡因 脑灌注压 脑肿瘤 麻醉 

分 类 号：R971.2[医药卫生—药品] R739.410.5[医药卫生—药学]