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

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

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。

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.