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目的 观察异丙酚、普鲁卡因对颅内压 (ICP)和脑灌注压 (CPP)的影响。方法 2 5例脑肿瘤病人随机分成异丙酚组 (D组 )和普鲁卡因组 (P组 )。局麻下钻孔于颅骨及脑膜间安置SP -2 0 0 0型颅内压监护仪 ,连续监测ICP ,同时用Colin5 0 8连续监测MAP、HR及PETCO2。静注异丙酚2mg/kg后 ,输注异丙酚 10 0～ 15 0 μg·kg-1·min-1或普鲁卡因 1mg·kg-1·min-130min ,观察ICP、MAP及CPP的变化。结果 静注异丙酚 2mg/kg后 ,两组病人ICP、MAP及CPP较诱导前有显著性降低(P <0 0 5 ) ,两组间无明显差异 (P >0 0 5 )。D组病人维持期 ,ICP持续低于诱导前水平下降幅度18%～ 47% ,MAP、CPP回升至诱导前水平 ,维持稳定。P组病人ICP也低于诱导前水平 ,下降幅度15 %～ 30 % ,和D组间比较无显著差异 (P >0 0 5 )。插管后 2 0分钟 ,MAP、CPP及HR较诱导前和D组明显增加 (P <0 0 5 )。结论 异丙酚静脉麻醉更适宜神经外科手术。
Objective To observe the effects of propofol and procaine on intracranial pressure (ICP) and cerebral perfusion pressure (CPP). Methods Twenty-five brain tumor patients were randomly divided into propofol group (D group) and procaine group (P group). Under local anesthesia, an SP-2000 intracranial pressure monitor was placed between the skull and the meninges to monitor the ICP continuously. Meanwhile, MAP, HR and PETCO2 were continuously monitored by Colin5 0 8. After propofol 2 mg / kg was intravenously injected, propofol was infused from 10 to 150 μg · kg-1 · min-1 or procaine 1 mg · kg-1 · min-130 min. ICP, MAP and CPP The change. Results After intravenous propofol 2 mg / kg, ICP, MAP and CPP in both groups were significantly lower than those before induction (P <0.05), with no significant difference between the two groups (P> 0.05). In group D, the duration of ICP maintenance was 18% -47% lower than that of pre-induction, MAP and CPP returned to their pre-induction level, and remained stable. The ICP of group P was also lower than that of pre-induction, with a decrease of 15% -30%. There was no significant difference between group D and group D (P> 0.05). At 20 minutes after intubation, MAP, CPP and HR increased significantly compared with that before induction and in group D (P <0.05). Conclusion Propofol is more suitable for neurosurgery.