尼卡地平控制性降压对局部脑氧饱和度的影响

Influence on regional oxygen saturation of deliberate hypotension using nicardipine

目的观察颅内动脉瘤夹闭术中控制性降压对局部脑氧饱和度(rScO2)的影响。方法 15例ASAⅠ级的择期颅内动脉瘤夹闭手术患者,丙泊酚-瑞芬太尼全凭静脉麻醉,暴露动脉瘤期间静脉泵注尼卡地平0.5～1μg·kg-1·min-1,逐渐降低术前基础MAP的10%、20%和30%,夹闭动脉瘤后停止降压,观察降压过程中MAP、HR和rScO2的变化趋势。结果尼卡地平控制性降压过程中,随着MAP的逐渐下降,rScO2略有升高,T5时rScO2恢复至T1水平,各时点MAP、HR、PETCO2、BIS和rScO2差异均无统计学意义。结论颅内动脉瘤夹闭术中应用尼卡地平行控制性降压安全可行,不会影响脑氧供需平衡。

Objective To investigate the influence of deliberated hypotension using nicardipine on regional oxygen saturation （ rScO2 ）. Methoch Fifteen ASA I patients scheduled for elective aneurysm clipping surgery were included. Total intravenous anesthesia was applied with propofol and remifentanil. Deliberate hypotension was induced by 0. 5-1 μg. kg-1· min nicardipine until clipping was completed, and mean arterial pressure （MAP） was gradually decreased 10%, 20% and 30% below baseline. rScO2 was recorded together with MAP and HR. Results Controlled hypotension, with the gradual decline of the MAP, rScO2 was increased in T5, rScO2 returned to T1 level. Each time poim MAP, HR, PETCO2, BIS and rSmO2 were not significantly different. Conclusion Nicardipine can be safely used in deliberate hypotension in aneurysm clipping surgery without affecting cerebral oxygen balance.