【摘要】 目的　比较异丙酚和咪唑安定麻醉在脑肿瘤患者的手术中对颅内压的影响。方法　选择 2 0例开颅手术的脑肿瘤患者随机分成异丙酚组 (Ⅰ组 ,n =10 )和对照组咪唑安定组 (Ⅱ组 ,n =10 ) ,两组患者均取左侧卧位选择L3～ 4间隙穿刺 ,监测颅内压 (ICP) ;并监测记录ICP、收缩压 (SBP)、舒张压 (DBP)。在麻醉前 ,麻醉诱导后 2、4min ,插管后 2、4、6、8、10min ,切皮及钻颅等时点的数值进行对比分析。结果　两组患者之间在诱导后 2min时ICP差异有显著性 (P <0 0 5 ) ,其他时点的ICP比较差异无显著性 ;两组患者之间SBP、DBP比较差异无显著性 (P >0 0 5 )。Ⅰ组诱导后 4minSBP和DBP与基础比差异有显著性 (P <0 0 5 ) ,ICP与基础比差异无显著性 (P >0 0 5 )。Ⅱ组诱导后 4min和插管后 6min的SBP、DBP与基础比差异有显著性 (P <0 0 5 ) ,ICP与基础比差异无显著性 (P >0 0 5 )。结论　异丙酚和咪唑安定用于脑肿瘤患者的麻醉 ,都能维持稳定的颅内压 ,但咪唑安定对血压的影响较异丙酚大 ,因此异丙酚更安全有利。更多还原

【Abstract】 Objective To compare different effects of propofol with midazolam on intracranial pressure (ICP) during craniotomy. Methods 20 patients, who had an intracranial tumor with an anterior craniotomy, had been randomly divided into propofol group (group Ⅰ, n =10) and midazolam group (group Ⅱ, n =10). ICP was monitored through spinal acupuncture in left side up position. SBP, DBP, HR, ICP were observed before anesthesia, 2 and 4 min after induction 2, 4, 6, 8, 10 min post intubation, and at the begining of operation and crania drilling. Results ICP between the two groups after induction 2 min was significantly different ( P< 0 05). In group I, there were significant difference in SBP and DBP 4 min after induction with preoperation ( P< 0 05). In group Ⅱ, SBP and DBP were significantly lower at 4 and 6 min that before operation ( P< 0 05). Conclusion Both propofol and midazolam can keep ICP of intracranial tumor patients stable during anesthesia. As far as different effects on blood pressure are concerned, propofol is more safe than midazolam.更多还原