Effects of propofol on cerebral blood flow and the metabolic rate of oxygen in humans
Effects of propofol on cerebral blood flow and the metabolic rate of oxygen in humans
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DOI：
10.1034/j.1399-6576.2002.460713.x
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发表时间：
2002-08-01
影响因子：
2.1
通讯作者：
Satoh, T
中科院分区：
文献类型：
--
作者：
Oshima, T;Karasawa, F;Satoh, T
背景：异丙酚对人脑血流量（CBF）、脑氧代谢率（CMRO2）以及血流-代谢耦合的影响尚未得到充分评估。因此，我们评估了丙泊酚对无伤害性刺激和神经系统疾病的患者总CBF和CMRO2的影响。方法：对10名接受膝关节内镜手术的患者（ASA身体状况I）采用咪达唑仑（0.2 mg/kg）和芬太尼（5 μg/kg）进行全身麻醉。还进行硬膜外麻醉以避免手术期间的有害刺激。丙泊酚输注前后（6 mg/kg/h，40 min）采用Kety-Schmidt法以15% N-2 O为示踪剂测定脑血流量（CBF）和脑动静脉氧含量差（a-vDO（2）），并计算CMRO2。结果：丙泊酚输注后CBF从34.4 ml/100 g/min（范围）下降28.4-52.0）至 30.0 毫升/100 克/分钟（范围 20.2-42.4）（P = 0.04）。虽然a-vDO(2)没有显着变化，但丙泊酚输注后CMRO2从2.7ml/100g/min（范围2.2-4.3）降低至2.2ml/100g/min（范围1.4-3.0）（P=0.04）。 CBF和CMRO2之间存在很强的线性相关性(r=0.90)。结论：异丙酚成比例地降低CBF和CMRO2而不影响人类的a-vDO(2)，表明正常的脑循环和代谢得以维持。
Background: Effects of propofol on human cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2 ), and blood flow-metabolism coupling have not been fully evaluated. We therefore assessed the effects of propofol on total-CBF and CMRO2 in patients without noxious stimuli and neurologic disorders.Methods: General anesthesia was induced with midazolam (0.2 mg/kg) and fentanyl (5 mug/kg) in 10 patients (ASA physical status I) undergoing knee joint endoscopic surgery. Epidural anesthesia was also performed to avoid noxious stimuli during surgery. Cerebral blood flow (CBF) and cerebral arteriovenous oxygen content difference (a-vDO(2) ) was measured using the Kety-Schmidt method with 15% N-2 O as a tracer before and after propofol infusion (6 mg/kg/h for 40 min), and the CMRO2 was also calculated.Results: CBF decreased following propofol infusion from 34.4 ml/100 g/min (range 28.4-52.0) to 30.0 ml/100 g/min (range 20.2-42.4) (P =0.04). Although there was no significant change in a-vDO(2) , CMRO2 decreased following propofol infusion from 2.7 ml/100 g/min (range 2.2-4.3) to 2.2 ml/100 g/min (range 1.4-3.0) (P =0.04). There was a strong linear correlation between CBF and CMRO2 (r= 0.90).Conclusion: Propofol proportionally decreased CBF and CMRO2 without affecting a-vDO(2) in humans, suggesting that normal cerebral circulation and metabolism are maintained.