尼卡地平控制性降压对颅内压的影响

Effects of deliberate hypotension with nicardipine on intracranial pressure in patients undergoing neurosurgery

目的观察尼卡地平控制性降压对颅内压(ICP)的影响。方法选择ASA I或Ⅱ级神经外科手术患者20例,年龄19～50岁。行腰椎穿刺术直接测得ICP。尼卡地平起始剂量为0.01%～0.02%的溶液静脉滴注,维持SBP在100 mm Hg以下。记录降压前(T0)、降压10 min(T1)、20min(T2)、30 min(T3)和结束降压后10 min(T4)、20 min(T5)的ICP、rSO2、HR、MAP。结果T1～T3时MAP显著低于T0(P<0.01)。T4时MAP明显回升(P<0.05),T5时回到T0水平。降压期间ICP、rSO2、HR无明显改变。结论尼卡地平降压起效快,降压平稳,对ICP、脑氧饱和度无明显影响。

Objective To observe the effects of deliberate hypotension with nicardipine on intracranial pressure（ICP） in patients undergoing neurosurgery. Methods Twenty ASA class Ⅰ or Ⅱ patients,aged from 19 to 50 years old and scheduled for selective neurosurgical operations were envolled in this study. Nicardipine 0.01%-0. 02% was infused to keep systolic blood pressure under 100 mm Hg. The ICP was monitored directly by spinal puncture. ICP, rSO2, HR, MAP were recorded at before hypotension （T0）, after hypotension 10 rain（T1 ）, 20 min（T2 ）, 30 min（T3 ）, stopping hypotension 10 Min （T4）, 20 min （T5）. Results The MAP was obviously lower at T1 to T3 than that at To （P〈0. 01）. The MAP returned to the baseline at T5. There were no notable alterations in ICP, oxygen saturation of the brain and HR during deliberate hypotension. Conclusion Deliberate hypotension with nicardipine infusion is quick in onset and smooth in decrease of blood pressure,and has no remarkable effect on HR, ICP and oxygen saturation of the brain.