全麻气管内插管时颅内压增高的预防

PREVENTION OF INTRACRANIAL PRESSURE INCREASE DURING TRACHEAL INTUBATION

对60例颅内手术患者行颅内压和平均动脉压监测,结果表明:单独静脉注射芬太尼或与布比卡因合用,可防止气管内插管所致颅内压增高并减弱心血管反应。单用布比卡因则仅可防止颅内压增高。安定适用于颅脑手术麻醉;琥珀酰胆缄和低浓度氯按酮如使用得法,并不增加颅内压;如颅内占位性病变不过大,导氟醚对颅内手术也是安全的。

Intracranial pressure (ICP) and mean arterial pressure (MAP) were monitored in 60 patients recieving intracranial surgery under general anesthesia with special note during tracheal intubation. It was found that intravenous administration of fentanyl or fentanyl and bupivacaine could block the alarming increase of ICP and blunt the cardiovascular response during the process of tracheal intubation. Bupivacaine alone could block the increase of ICP but not the MAP. Succinylcholine and low-concentration ketamine did not increase ICP when they were properly used, and isoflurane was safe in intracranial surgery provided that the intracranial occupying lesion was not too large.