【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 3 0例 ,所有病人随机分为 2组 :异氟醚麻醉组 (ISO组 ,n =1 5 )和尼莫地平输注组 (NIMO组 ,n =1 5 )。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 2 0 μg/ (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 2 0 μg/ (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 2 0 μg/ (kg·h)尼莫地平对全身血流动力学的影响在安全范围内更多还原

【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.更多还原