Cerebral blood flow affects dose requirements of intracarotid propofol for electrocerebral silence
Cerebral blood flow affects dose requirements of intracarotid propofol for electrocerebral silence
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DOI：
10.1097/00000542-200602000-00014
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发表时间：
2006-02-01
期刊：
影响因子：
8.8
通讯作者：
Pile-Spellman, J
中科院分区：
文献类型：
--
作者：
Joshi, S;Wang, M;Pile-Spellman, J
背景资料：作者假设，脑血流量（CBF）的变化将影响剂量的颈动脉内异丙酚需要产生electrocerebral silence.Methods：作者测试他们的假设对新西兰白色兔。第一组9只动物在（1）正常通气、（2）过度通气和（3）通气不足期间接受颈动脉内丙泊酚。第二组14只动物接受颈动脉内丙泊酚，同时动脉内维拉帕米，一种有效的脑血管扩张剂。第三组8只动物在正常血压、严重脑灌注不足和血流动力学恢复后接受丙泊酚推注。在第一组中，由于每分钟通气量的变化，颈动脉内丙泊酚剂量与CBF相对于基线的百分比变化（%Delta）之间存在线性相关性，总剂量（y）= 0.17 + 0.012* %Delta CBF（x），n = 27，r = 0.76。在第二组中，丙泊酚剂量也是维拉帕米后CBF变化的函数，总剂量（y）= 0.98 + 0.1* %Delta CBF（x），n = 14，r = 0.75。在第三组中，与低灌注前和低灌注后值相比，颈动脉内丙泊酚（3 mg）后脑电沉默的持续时间在脑低灌注时显著增加（分别为141 +/- 38 vs. 19 +/- 24和16 +/- 12 s，P < 0.0001）。作者得出结论，CBF影响产生脑电静默所需的颈动脉内丙泊酚的剂量要求。此外，CBF的操纵可能是一个有用的工具，以提高颈动脉内药物的疗效。
Background: The authors hypothesized that cerebral blood flow (CBF) changes will affect the dose of intracarotid propofol required to produce electrocerebral silence.Methods: The authors tested their hypothesis on New Zealand White rabbits. The first group of 9 animals received intracarotid propofol during (1) normoventilation, (2) hyperventilation, and (3) hypoventilation. The second group of 14 animals received intracarotid propofol with or without concurrent intraarterial verapamil, a potent cerebral vasodilator. The third group of 8 animals received bolus injection of propofol during normotension, during severe cerebral hypoperfusion, and after hemodynamic recovery.Results: In the first group, there was a linear correlation between the dose of intracarotid propofol and percent change (%Delta) in CBF from the baseline due to changes in the minute ventilation, Total Dose (y) = 0.17 + 0.012* %Delta CBF (x), n = 27, r = 0.76. In the second group, the dose of propofol was also a function of CBF change after verapamil, Total Dose (y) = 0.98 + 0.1* %Delta CBF (x), n = 14, r = 0.75. In the third group, the duration of electrocerebral silence after intracarotid propofol (3 mg) was significantly increased with concurrent cerebral hypoperfusion compared with prehypoperfusion and posthypoperfusion values (141 +/- 38 vs. 19 +/- 24 and 16 +/- 12 s, respectively, P < 0.0001).Conclusions: The authors conclude that CBF affects the dose requirements of intracarotid propofol required to produce electrocerebral silence. Furthermore, the manipulation of CBF might be a useful tool to enhance the efficacy of intracarotid drugs.