Anesthetic technique influences brain temperature, independently of core temperature, during craniotomy in cats
Anesthetic technique influences brain temperature, independently of core temperature, during craniotomy in cats
复制标题
DOI：
10.1213/01.ane.0000061221.23197.ce
复制
发表时间：
2003-05-01
影响因子：
5.7
通讯作者：
Lanier, WL
中科院分区：
文献类型：
--
作者：
Erickson, KM;Lanier, WL
由于麻醉技术有可能显著影响脑血流量和代谢（脑温度调节的两个决定因素），我们测试了开颅手术后，麻醉技术会影响脑温度独立于核心温度的假设。21只猫（2.7 +/- 0.4 kg;平均值+/- SD）接受了统一的右侧颅骨旁切开术，接受了1）1.5%氟烷呼气末和正常碳酸血症（HN），2）1.5%氟烷和低碳酸血症（HH），或3）大剂量戊巴比妥和正常碳酸血症（PN）（每组n = 7）。加热装置最初维持核心和右侧硬膜下正常体温（38.0 ℃）。此后，停止颅骨加热。在3小时研究期间，右侧硬膜下区域的脑-核心温度梯度最大，HN平均为-2.5 ℃ +/-0.9 ℃，HH平均为-2.5 ℃ +/-0.8 ℃，PN平均为-4.1 ℃ +/-1.1 ℃。对于HN和HH，未暴露的左侧硬膜下区域和脑表面以下0.5和1.0 cm的右侧皮质中的温度为-0.8 ℃ +/-0.5 ℃至-1.1 ℃ +/-0.6 ℃，但PN中的温度为该值的两倍（-1.9 ℃ +/-0.5 ℃至-2.1 ℃ +/-0.7 ℃）（PN与HN和HH相比P < 0.05）。深度巴比妥酸盐麻醉可以独立于核心温度降低脑温，可能是通过降低代谢率和相关的脑热产生。该量级足以增强巴比妥类药物的任何直接的神经保护特性。
Because anesthetic technique has the potential to dramatically affect cerebral blood flow and metabolism (two determinants of brain thermoregulation), we tested the hypothesis that, after craniotomy, anesthetic technique would influence brain temperature independent of core temperature. Twenty-one cats (2.7 +/- 0.4 kg; mean +/- SD) undergoing a uniform right parasagittal craniotomy received 1) halothane 1.5% end-expired and normocapnia (HN), 2) halothane 1.5% and hypocapnia (HH), or 3) large-dose pentobarbital and normocapnia (PN) (n = 7 per group). Heating devices initially maintained core and right subdural normothermia (38.0degreesC). Thereafter, cranial heating was discontinued. Brain-to-core temperature gradients during the 3 h study were greatest in the right subdural area, averaging -2.5degreesC +/- 0.9degreesC in HN, -2.5degreesC +/- 0.8degreesC in HH, and -4.1degreesC +/- 1.1degreesC in PN. Gradients within the unexposed left subdural area and in the right cortex 0.5 and 1.0 cm below the brain surface were -0.8degreesC +/- 0.5degreesC to - 1.1degreesC +/- 0.6degreesC for both HN and HH but were twice this amount in PN (-1.9degreesC +/- 0.5degreesC to -2.1degreesC +/- 0.7degreesC) (P < 0.05 for PN versus HN and HH). Deep barbiturate anesthesia can reduce brain temperature independently of core temperature, presumably by reducing the metabolic rate and associated brain heat production. The magnitude is sufficient to augment any direct cerebro-protective properties of the barbiturates.