欢迎来到天天文库
浏览记录
ID:43215570
大小:385.31 KB
页数:13页
时间:2019-10-03
《氟醚静脉麻醉脊髓血流量的变化》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、SpinalCordBloodFlowChangebyIntravenousMidazolamDuringIsofluraneAnesthesiaTomokiNishiyama,MD,PhDByCorallibraBackgroundMidazolamhasbeenusedforgeneralanesthesiaandsedationduringlocalanesthesiaorartificialventilation.IthasbecomeclearthatmidazolamhasananalgesicpropertymediatedbyGABAreceptorsinthespin
2、alcord.Therefore,itisimportanttoknowtheeffectsofmidazolamonspinalcordbloodflow.MethodsanesthesiamaintainventilationMethodsMidlineskinincision,L1-5wereremoved,andthespinalcordwasexposed.Aplatinumwasinsertedstereotaxicallyintothespinalcordtoadepthof1mmat2mmlateraltothemidlineatL2.Spinalcordbloodfl
3、owwasmeasuredeiththehydrogenclearancemethod.Statisticalanalysiswasperformedwithrepeated-measuresanalysisofvarianceResultsArterialbloodgasvaluesbeforethestudydrugtreatmentwithoutanydifference.Arterialbloodpressuredecreasedduringthefirst30minafterMID2and4mg/KgHeartratedidnotchange.ResultsSpinalcor
4、dbloodflowincreasedsignificantlyfor90minafterMID1mg/Kgandfor15minafterMID2mg/Kg.DiscussionSpinalcordbloodflowwasincreasedbythesmallestdoseofIVmidazolamused(1mg/kg)withoutanychangesinarterialbloodpressureThelargestdose(4mg/kg)didnotinduceanychangesinspinalcordbloodflowbutdecreasedarterialbloodpre
5、ssureDiscussionSpinalcordbloodflowincreasedasETco2increased,butitdidnotchangewithmeanarterialbloodpressurebetween50and135mmHgorwithPao2morethan40mmHg(arterialbloodpressurewasintherangeofautoregulation)DiscussionSpinalcordbloodflowmightchangesimilarlytocerebralbloodflowBolusmidazolam(0.15mg/kg)de
6、creasedcerebralbloodflow,butmeanarterialbloodpressurealsodecreasedDiscussionIsofluraneincreasedspinalcordbloodflowwithinthearterialbloodpressurerangeof90–130mmHgThedecreaseinarterialbloodpressureinthemidazolam2and4mg/kggroupsmayhavedecreasedspinalcordbloodflowduringisofluraneanesthesiathatmasked
7、theincreaseotherwisecausedbymidazolamDiscussionHowever,inpatients,midazolamisoftencoadministeredwithotheranestheticsToknowtheeffectsofmidazolam,isofluraneshouldbediscontinuedConclusionAsmallerdoseofmidazolam(1mg/kg)increased
此文档下载收益归作者所有