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目的 :观察静吸复合麻醉下 0 5、1 0MAC七氟醚对颅内压的影响。方法 :选颅内顺应性正常的择期行垂体瘤或颅咽管瘤手术患者 16例 ,随机分为两组 :A组用咪唑安定 +芬太尼 + 0 5MAC七氟醚 ;B组咪唑安定 +芬太尼+ 1 0MAC七氟醚。于L3～ 4穿刺至蛛网膜下腔以监测腰部脑脊液压 (ISP)。麻醉诱导采用芬太尼 咪唑安定 阿曲库铵。气管内插管后静脉泵入咪唑安定 0 1mg·kg-1·h-1、阿曲库铵 0 5mg·kg-1·h-1。插管后稳定 3 0分钟开始吸入七氟醚。分别于麻醉诱导前、吸入七氟醚前、达预定呼气末七氟醚浓度即刻、5、10、15、2 0、3 0分钟时观察并记录各监测指标。结果 :吸入 0 5MAC七氟醚后颅内压逐渐上升 ,达预定浓度后 3 0分钟上升 11 2 % ;吸入 1 0MAC七氟醚后颅内压首先呈显著性下降 ,15分钟后逐渐回复至基础水平。结论 :0 5、1 0MAC七氟醚可安全用于神经外科颅内顺应性正常的患者。
OBJECTIVE: To observe the effects of sevoflurane 0,01,0 MAC on intracranial pressure under combined inhalation anesthesia. Methods: Totally 16 patients with pituitary tumor or craniopharyngioma undergoing elective surgery were randomly divided into two groups: group A was treated with midazolam + fentanyl + 05MAC sevoflurane; group B was treated with midazolam + Fentanyl + 10MAC Sevoflurane. Puncture the subarachnoid space at L3-4 to monitor lumbar cerebrospinal fluid pressure (ISP). Induction of anesthesia with fentanyl midazolam and atracurium. After intratracheal intubation, midazolam 0 1 mg · kg-1 · h-1 and atracurium 0 5 mg · kg-1 · h-1 were administered. Thirty minutes after intubation began to inhale sevoflurane. Respectively before induction of anesthesia, before inhalation of sevoflurane, up to the end of the scheduled expiratory sevoflurane concentration immediately, 5,10,15,2 0,3 minutes observed and recorded monitoring indicators. Results: Intracranial pressure increased gradually after inhaling 0 5MAC sevoflurane, reaching 11 2% at 30 minutes after inhaling 10 MAC sevoflurane. After inhaling 10MAC sevoflurane, intracranial pressure first decreased significantly, and gradually returned to the baseline after 15 minutes Level. CONCLUSION: 0 5,1 0 MAC sevoflurane is safe for patients with normal intracranial neurosurgery.