Effects of one minimum alveolar anesthetic concentration sevoflurane on cerebral metabolism, blood flow, and CO2 reactivity in cardiac patients.
Effects of one minimum alveolar anesthetic concentration sevoflurane on cerebral metabolism, blood flow, and CO2 reactivity in cardiac patients.
复制标题
一种最低肺泡麻醉浓度七氟醚对心脏病患者脑代谢、血流量和 CO2 反应性的影响。
DOI：
10.1213/00000539-199908000-00022
复制
发表时间：
1999
影响因子：
5.7
通讯作者：
Hans Sonntag
中科院分区：
文献类型：
--
作者：
Frank Mielck;H. Stephan;Andreas Weyland;Hans Sonntag
未标记
我们研究了9例择期行冠状动脉旁路移植术的男性患者使用1个最低肺泡麻醉浓度（MAC）的七氟醚麻醉对脑血流动力学的影响。采用改良的Kety-Schmidt饱和技术，以氩气作为惰性示踪气体，测量脑血流量（CBF）。在麻醉诱导前和麻醉诱导后30 min，分别在正常碳酸、低碳酸和高碳酸条件下测量CBF。与正常碳酸条件下的清醒状态相比，七氟烷使平均脑氧代谢率降低47%，平均脑葡萄糖代谢率降低39%。同时，CBF降低了38%，尽管平均动脉压保持不变。颈静脉血氧饱和度无显著变化。低碳酸血症和高碳酸血症分别导致CBF减少51%和增加58%。这些由Paco 2变化引起的CBF变化表明在1 MAC七氟烷麻醉期间脑血管CO2反应性持续存在。
影响
我们使用改良的Kety-Schmidt饱和技术来研究1最小肺泡麻醉浓度（MAC）七氟烷对心脏病患者脑血流量、代谢和CO2反应性的影响。我们发现，全球脑血流量和全球脑氧代谢率保持耦合，脑血管CO2反应性不受1 MAC七氟烷给药的影响。
UNLABELLED
We investigated the cerebral hemodynamic effects of 1 minimum alveolar anesthetic concentration (MAC) sevoflurane anesthesia in nine male patients scheduled for elective coronary bypass grafting. For measurement of cerebral blood flow (CBF), a modified Kety-Schmidt saturation technique was used with argon as an inert tracer gas. Measurements of CBF were performed before the induction of anesthesia and 30 min after induction under normocapnic, hypocapnic, and hypercapnic conditions. Compared with the awake state under normocapnic conditions, sevoflurane reduced the mean cerebral metabolic rate of oxygen by 47% and the mean cerebral metabolic rate of glucose by 39%. Concomitantly, CBF was reduced by 38%, although mean arterial pressure was kept constant. Significant changes in jugular venous oxygen saturation were absent. Hypocapnia and hypercapnia caused a 51% decrease and a 58% increase in CBF, respectively. These changes in CBF caused by variation of Paco2 indicate that cerebrovascular CO2 reactivity persists during 1 MAC sevoflurane anesthesia.
IMPLICATIONS
We used a modified Kety-Schmidt saturation technique to investigate the effects of 1 minimum alveolar anesthetic concentration (MAC) sevoflurane on cerebral blood flow, metabolism, and CO2 reactivity in cardiac patients. We found that the global cerebral blood flow and global cerebral metabolic rate of oxygen remained coupled and that cerebrovascular CO2 reactivity is not impaired by the administration of 1 MAC sevoflurane.