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題 名 | The Dose Effect of Propofol on Cerebrovascular Reactivity to Carbon Dioxide in Rabbits=Propofol的劑量對腦血管二氧化碳反應性的影響 |
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作 者 | 康富期; 張倍榮; 王立楷; 宋儼惠; 陳宗鷹; 蔡玉娟; | 書刊名 | 麻醉學雜誌 |
卷 期 | 37:1 1999.03[民88.03] |
頁 次 | 頁3-8 |
分類號 | 416.5 |
關鍵詞 | 腦血管循環; 雷射都卜勒流量儀; 二氧化碳; Propofol; Cerebrovascular circulation; Laser-doppler flowmetry; Carbon dioxide; |
語 文 | 英文(English) |
中文摘要 | 背景:propofol使用於顱內手術具有許多優點,例如降低腦部代謝率與腦血流而 仍然保持完整的腦血流自動調節作用(autoregulation)。一些研究報告顯示在人體或動物實 驗,propofol麻醉時腦血流對血中二氧化碳分壓的改變仍維持其反應性。這些研究比較清 醒時與propofol麻醉時,腦血流與二氧化碳反應(CBF-CO□ reactivity)的斜率具有意義上 的差異,但並未比較不同propofol劑量的差異。本實驗使用雷射都卜勒流量測量法(laser Doppler flowmetry; LDF),觀察在不同劑量的propofol麻醉狀態下,腦血管對二氧化碳反 應性的差異。 方法:使用十隻兔子,以LDF測量其腦部頂葉皮質(parietal cortex)之血流。在手術準 備完成後,以混合66% N□O的氧氣、Morphine 10mg/kg、與pancuronium維持麻醉。三種 實驗狀況分別以靜脈注射如下三種藥物: (1)normal saline(對照組)(2)propofol: 20mg/kg/h(3)propofol:40mg/kg/h,維持穩定的平均動脈壓(MAP)、肛溫、與血容比(Hct)。 在每一種實驗狀況時將動脈二氧化碳分壓(PaCO□)調整到三個範圍:20-25 mmHg(低血碳 酸),35-40 mmHg(正常血碳酸),45-50 mmHg(高血碳酸)。持續測量腦血流,當PaCO□達到 三個目標範圍時,記錄其腦血流。 結果:在三種不同濃度的propofol時,平均動脈壓與比跳均無差異。比較在三個不同的 PaCO□範圍時,腦血流均有意義上之不同(P<0.05),但CBF-CO□反應性的斜率在三種不同 的propofol劑量下並無顯著的差異。 結論:吾人實驗結果顯示在propofol麻醉中,腦血管對二氧化碳的反應性仍然存在;當 MAP恆定時,在不同的propofol劑量下,CBF-CO□反應性的斜率並無意義上的差異。 |
英文摘要 | Background: Propofol has several properties beneficial to intracranial operation such as reduction in cerebral metabolic rate and cerebral blood flow (CBF) in a dose-dependent manner while leaving autoregulation intact. Several studies have demonstrated that the responsiveness of CBF to changes in arterial carbon dioxide tension (PaCO□) is maintained during propofol anesthesia in both humans and animals. These studies showed a significant difference in the CBF-CO□ reactivity slope between awake and propofol anaesthetized groups, but no comparison with different doses of propofol was made. To determine the dose effect of propofol on cerebrolvascular CO□ reactivity, we used laser Doppler flowmetry (LDF) to detect the changes of CBF during propofol anesthesia. Methods: Ten rabbits were studied using LDF on the parietal cortex. After surgical preparation, anesthesia was maintained with 66% N□O in O□, morphine 10 mg/kg and pancuronium. Three experimental conditions were studied sequentially with intravenous administration of the following drugs: (1) normal saline (control), (2) propofol 20 mg/kg/h iv., (3) propofol 40 mg/kg/h iv. Mean arterial pressure, rectal temperature and hematocrit were kept constant. The arterial carbon dioxide tension (PaCO□) was adjusted to three levels during each condition: 20-25 mmHg (hypocapnia), 35-40 mmHg (normocapnia) and 45-50 mmHg (hypercapnia). CBF was measured continuously and recorded after the target PaCO□ had been reached. Results: There were no differences among all conditions in mean arterial pressure and heart rate. The changes of CBF as PaCO□ increased at the three different CO □ levels during each of the conditions were significantly different. The slope of CBF-C0□ reactivity among three different propofol doses was not significantly different. Conclusions: These data indicate that cerebral vasomotor responsiveness to CO □ during propofol anesthesia is preserved and that the slope of CBF-CO□ reactivity is independent of propofol doses as mean arterial blood pressure is maintained. |
本系統中英文摘要資訊取自各篇刊載內容。