持续输注尼莫地平对颅内动脉瘤夹闭术术中血流动力学的影响

首都医科大学学报 ›› 2004, Vol. 25 ›› Issue (3): 383-386.

持续输注尼莫地平对颅内动脉瘤夹闭术术中血流动力学的影响

韩如泉¹, 陆峥², 王保国¹, 王恩真¹, 王硕², 赵继宗²

1. 首都医科大学附属北京天坛医院麻醉科;2. 天坛医院神经外科

收稿日期:2003-06-04 修回日期:1900-01-01 出版日期:2004-07-15 发布日期:2004-07-15

Effect of Intraoperative Continuous Nimodipine Infusion on Systemic Hemodynamics in Aneurysm Surgery

Han Ruquan¹, Lu Zheng², Wang Baoguo¹, Wang Enzhen¹, Wang Shuo², Zhao Jizong²

1. Department of Anesthesiology, Beijing Tiantan Hospital, Affiliate of Capital University of Medical Sciences;2. Department of Neurosurgery, Beijing Tiantan Hospital

Received:2003-06-04 Revised:1900-01-01 Online:2004-07-15 Published:2004-07-15

摘要/Abstract

摘要： 为研究异氟醚麻醉复合持续输注尼莫地平对血流动力学的影响,选择颅内动脉瘤夹闭术病人30例,所有病人随机分为2组:异氟醚麻醉组(ISO组,n=15)和尼莫地平输注组(NIMO组,n=15).ISO组术中吸入1MAC异氟醚维持麻醉.NIMO组在诱导后使用微量泵开始持续匀速输注尼莫地平20μg/(kg·h),直至手术结束,同时吸入1MAC异氟醚维持麻醉.分别于诱导前、切皮时、硬膜切开时、动脉瘤夹闭前、夹闭后、关硬膜时、缝皮时测定病人的血流动力学的变化.结果:术中持续输注尼莫地平20μg/(kg·h)可显著降低血压,但降低幅度均在临床安全范围内,心率无显著变化;输注尼莫地平后外周血管阻力显著下降,而心输出量、心脏收缩加速度均显著增加.提示:在颅内动脉瘤夹闭术术中持续输注20μg/(kg·h)尼莫地平对全身血流动力学的影响在安全范围内.

关键词: 动脉瘤, 多普勒超声, 异氟醚, 尼莫地平

Abstract: The aim of this study was to evaluate the effect of intraoperative continuous nimodipine infusion on systemic hemodynamics in intracranial aneurysm surgery.Thirty consecutive patients undergoing intracranial aneurysmal surgery without a preexisting cerebral ischemia were prospectively randomized into one of two groups: Isoflurane maintained anesthesia (group A, n=15) and nimodipine + isoflurane maintained anesthesia (group B, n=15).The patients in group B were given nimodipine infusion continuously 20 μg/(kg·h) after induction of anesthesia and anesthetized with 1 MAC isoflurane.The patients in group A were maintained with 1 MAC isoflurane anesthesia during the whole procedure.Systemic hemodynamics were monitored intraoperatively.Mean arterial pressure (MAP) were lower significantly in group B than that in group A, but MAP were kept in clinical safe range.Heart rates were kept stable.However, cardiac output, cardiac index, myocardial contract acceleration increased significantly in group B, and systemic vascular resistance decreased after nimodipine infused.Conclusion: Systemic hemodynamics during intraoperative continuous nimodipine 20 μg/(kg·h) infusion combined with 1 MAC isoflurane anesthesia are in clinical safe range.

Key words: aneurysm, doppler, isoflurane, nimodipine

中图分类号:

韩如泉;陆峥;王保国;王恩真;王硕;赵继宗. 持续输注尼莫地平对颅内动脉瘤夹闭术术中血流动力学的影响[J]. 首都医科大学学报, 2004, 25(3): 383-386.

Han Ruquan;Lu Zheng;Wang Baoguo;Wang Enzhen;Wang Shuo;Zhao Jizong. Effect of Intraoperative Continuous Nimodipine Infusion on Systemic Hemodynamics in Aneurysm Surgery[J]. Journal of Capital Medical University, 2004, 25(3): 383-386.

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