| Japanese |
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| Title | 頭蓋内圧亢進時における低血圧麻酔の頭蓋内圧に及ぼす影響-ニトロプルシッド, トリメタファン, ハロセン深麻酔の比較- |
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| Subtitle | |
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| Authors | 森井誠二*, 劒物修** |
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| Organization | *北里大学医学部脳神経外科, **北里大学医学部麻酔科 |
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| Journal | 循環制御 |
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| Volume | 5 |
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| Number | 2 |
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| Page | 233-241 |
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| Year/Month | 1984/ |
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| Article | 原著 |
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| Publisher | 日本循環制御研究会 |
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| Abstract | 「要旨」31頭の雑種成犬で頭蓋内圧亢進状態を作成し, ニトロプルシッド, トリメタファン, ハロセン深麻酔の頭蓋内圧に及ぼす影響を比較検討した. 麻酔の維持はハロセン/笑気により行い, 呼吸はPaco2を37mmHgに維持するように調節した. 頭蓋内圧は硬膜下バルーン法により測定し, 頭蓋内圧亢進は硬膜外バルーン法により作成した. 平均動脈圧を99mmHgから55mmHgに各薬物により低下させ, 頭蓋内圧を30mmHgと35mmHgに維持することで, 脳灌流圧を25mmHgと20mmHgに30分間保持した. 低血圧麻酔を終了後の頭蓋内圧の推移をみると, 脳灌流圧を20mmHgに維持した場合には不可逆性の上昇をみた. 25mmHgに維持した場合には一過性の上昇をみたが, 可逆性の変化であった. 今回の成績から頭蓋内圧亢進時の脳灌流圧の安全限界は25mmHg, 30分間であることが示唆された. 低血圧麻酔の終了後, 急激に血圧の回復を計ることは, 時にニトロプルシッド, ハロセン深麻酔では避けるべきと思われた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | |
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| English |
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| Title | Comparative effects of drug-induced hypotension by nitroprusside, trimethaphan and deep halothane on intracranial pressure under intracranial hypertension |
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| Subtitle | |
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| Authors | Seiji Morii*, Osamu Kemmotsu** |
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| Authors(kana) | |
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| Organization | *Department of Neurosurgery, Kitasato University School of Medicine, **Department of Anesthesiology, Kitasato University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 5 |
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| Number | 2 |
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| Page | 233-241 |
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| Year/Month | 1984/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Thirty-one adult mongrel dogs were studied to compare the effects of drug-induced hypotension with either nitroprusside, trimethaphan or deep halothane on intracranial pressure (ICP) under experimentally produced intracranial hypertension. The dogs were divided into three groups: Group I (nitroprusside), Group II (trimethaphan) and Group III (deep halothane). Each group was subdivided into A) ICP: 30 mmHg and B) ICP: 35 mmHg. All dogs were anesthetized with halothane/nitrous oxide and respiration was controlled to maintain Paco2 about 37 mmHg. ICP was measured using a subdural balloon, and intracranial hypertension of 30mmHg or 35 mmHg was produced by inflation of an epidural balloon. The mean arterial pressure (MAP) was acutely reduced from 90 mmHg to 55 mmHg in the three different groups. During hypotension, cerebral perfusion pressure (CPP=MAP-ICP) of 25 mmHg (A) or 20 mmHg (B) was maintained for 30 minutes, and time courses of ICP were compared between different groups. The reduction of ICP was 41-48% in all groups. |
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| Practice | Basic medicine |
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| Keywords | induced hypotension, intracranial hypertension, intracranial pressure, cerebral perfusion pressure, critical level |
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