プロスタグランディンE₁，トリメタファンによる人為的低血圧が脳神経外科患者の脳皮質血流におよぼす影響

Abstract

Cerebral cortical blood flow (CBF) and autoregulatory function of CBF were elucidated with thermo-clearance (Peltier method) and determined mean arterial pressure (MAP), systolic arterial pressure (SAP), and diastolic arterial pressure (DAP), in 20 neurosurgical patients who had been anesthetized with diazepam, fentanyl and nitrousoxide/oxygen inhalation with deliberate hypotension by prostaglandin E₁ (PGE₁) and trimetaphan (TMP). In PGE₁ group (n=11) CBF revealed no significant change when MAP was reduced from 99±16 mmHg to 76±10 mmHg. In TMP group (n=9), CBF revealed no marked alteration when MAP was reduced from 111±13 mmHg to 82±11 mmHg (26% reduction), while it significantly decreased when MAP was reduced to 74±7 mmHg (34% reduction) (p<0.005). In conclusion, these results suggest that physiological autoregulatory function is maintained during MAP keeping from 82 mmHg to 74 mmHg level (critical MAP) in deliberate hypotension with TMP.