高浓度七氟醚诱导对髓核摘除术患者脑血流速度的影响

Effect of anesthesia induction with high concentration of sevoflurane on the velocity of cerebral blood flow

目的观察吸入高浓度七氟醚（8％）诱导时大脑中动脉血流速度的变化。方法椎间盘突出择期行髓核摘除的患者24例，年龄35-55岁，ASAI或Ⅱ级，依诱导方式的不同随机均分为两组，8％七氟醚吸入组（S组）和靶控输注（TCI）丙泊酚－瑞芬太尼组（P组）。记录诱导前（T0）、诱导后1min（T1）、2min（T2）、3min（T3）时的脑血流平均速度（Vmean）、MAP及HR。结果T1时S组Vmean明显快于T0时及P组（P〈0．05），P组各时点Vmean变化差异无统计学意义。结论8％七氟醚吸入诱导可使脑血流速度加快，尤以诱导后1min最明显。

Objective To investigate the effect of anesthesia induction with high concentration of sevoflurane on the velocity of cerebral blood flow. Methods Twenty-four ASA physical status Ⅰ - Ⅱ patients （35-55 yr） scheduled for elective discectomy for lumbar intervertebral disc herniation were randomly assigned to two groups： group S was induced by inhalation with 8% sevoflurane; group P was induced with target-controlled infusion of propofol and remifentanil （target concentration.. 2. 0- 3.0 μg/ml and 5.0-6.0 ng/ml, respectively）. Blood flow velocity in the middle cerebral artery （Vmca） was measured using transcranial Doppler ultrasonography. Mean Vmca （Vmean）, MAP and HR were recorded before induction （To）, 1 rain （T1）, 2 rain （T2） and 3 min （T3） after induction. Results Vmean in group S at T1 increased significantly compared with the baseline in group S and that of group P at T1 （P〈0. 05）. Vmean in group P had no significant differences between various time points. Conclusion Anesthesia induction with 8% sevoflurane can accelerate the velocity of cerebral blood flow.