EFFECT OF NICARDIPINE AND DILTIAZEM ON INTERNAL CAROTID-ARTERY BLOOD-FLOW VELOCITY AND LOCAL CEREBRAL BLOOD-FLOW DURING CEREBRAL ANEURYSM SURGERY FOR SUBARACHNOID HEMORRHAGE
EFFECT OF NICARDIPINE AND DILTIAZEM ON INTERNAL CAROTID-ARTERY BLOOD-FLOW VELOCITY AND LOCAL CEREBRAL BLOOD-FLOW DURING CEREBRAL ANEURYSM SURGERY FOR SUBARACHNOID HEMORRHAGE
复制标题
DOI：
10.1016/0952-8180(94)90004-3
复制
发表时间：
1994-03-01
影响因子：
6.7
通讯作者：
INADA, E
中科院分区：
文献类型：
--
作者：
ABE, K;IWANAGA, H;INADA, E
研究目的：探讨异氟烷麻醉下推注尼卡地平 1 mg 或地尔硫卓 5 mg 对局部脑血流（LCBF）和颈内动脉血流速度（ICBFV）的血流动力学影响。设计：随机研究。地点：某市医院住院神经外科和麻醉门诊。患者：26 名拟行脑血管病的蛛网膜下腔出血患者动脉瘤夹闭术。干预措施：对打开硬脑膜后收缩压升高至 150 mmHg 以上的患者进行尼卡地平或地尔硫卓的推注。测量和主要结果：推注后，两种药物均迅速降低动脉血压。尼卡地平增加 LCBF [注射前，42.1 +/- 12.3 ml/100 g/min；注射后，47+/-10.7ml/100g/min； （与对照相比，p < 0.05）；恢复后 42.4 +/- 11.1 cm/sec]，但地尔硫卓没有改变 LCBF：尼卡地平 1 mg 中度增加 ICBFV [注射前，34.2 +/- 9.3 cm/sec；注射前，34.2 +/- 9.3 cm/sec；注射后，40.6 +/- 8.7 厘米/秒（与对照相比，p < 0.01）；恢复后，34.1+/-8.9厘米/秒]，但地尔硫卓没有改变ICBFV。此外，在整个研究过程中静脉氧分压和颈内静脉饱和度没有改变。术前神经系统状态与 LCBF (rs = - 0.743; p < 0. 01) 和 ICBFV (rs = - 0. 721; p < 0.01) 之间存在密切相关。结论：尼卡地平增加 LCBF 和 ICBFV：但地尔硫卓也没有改变。这些结果表明，这两种药物对于治疗脑动脉瘤手术期间的术中高血压是有用且安全的。
Study Objective: To determine the hemodynamic effects of a bolus injection of nicardipine 1 mg or diltiazem 5 mg on local cerebral blood flow (LCBF) and internal carotid blood flow velocity (ICBFV) with isoflurane anesthesia.Design: Randomized study.Setting: Inpatient neurosurgery and anesthesia clinic at a city hospital.Patients: 26 patients with subarachnoid hemorrhage who were scheduled for cerebral aneurysm clipping.Interventions: A bolus injection of either nicardipine or diltiazem was administered to patients whose systolic blood pressure increased to over 150 mmHg after opening of the dura.Measurements and Main Results: After the bolus injection, both drugs rapidly decreased arterial blood pressure. Nicardipine increased LCBF [before injection, 42.1 +/- 12.3 ml/100 g/min; after injection, 47 +/- 10.7 ml/100g/min; (p < 0.05 vs. control); after recovery 42.4 +/- 11.1 cm/sec], but diltiazem did not change LCBF: Nicardipine 1 mg moderately increased ICBFV [before injection, 34.2 +/- 9.3 cm/sec; after injection, 40.6 +/- 8.7 cm/sec (p < 0.01 vs, control); after recovery, 34.1 +/- 8.9 cm/sec], but diltiazem did not change ICBFV In addition, venous partial oxygen pressure and saturation of the internal jugular did not change throughout the study. There was a close correlation between presurgical neurologic status and LCBF (rs = - 0.743; p < 0. 01) and ICBFV (rs = - 0. 721; p < 0.01).Conclusions: Nicardipine increased LCBF and ICBFV: but diltiazem did not change either These results suggest that both drugs are useful and safe for the treatment of intraoperative hypertension during cerebral aneurysm surgery.