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上海市第一人民医院
纸质出版日期:1980
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庄心良, 屈桂莲, 周俊成, 等. 针麻和全麻诱导期间对脑脊液液压的影响[J]. 针刺研究, 1980,(2):118-120.
TAE FLUCTUATION OF CSF PRESSURE DURING INDUCTION CF ACUPUNCTURE ANESTHESIA AND GENERAL ANESTHESIA IN PATIENTS WITH INTRACRANIAL SPACE OCCUPYING LESIONS[J]. Acupuncture research, 1980, (2): 118-120.
有许多麻醉药和麻醉操作可以升高颅内压
原有颅内高压的病员这种作用可能更大。所以颅内压管理是这类病员在麻醉期间的重要问题。而针麻对颅内压增高病员的影响是怎样呢?我们对颅内有占位性病变作脑室引流患者
通过脑室引流管测定脑脊液液压
并与同类病员在全麻诱导期间对脑脊液液压的影响作对比。此外
我们还对其中10例在观察脑脊液液压变化的同时记录了脑血流图和耳垂血管容积波
依此探讨影响脑脊液液压的原因。
In order to sum up the clinical regularity of acupuncture anesthesia
serial observations on the flu-ctuation of cerebrospinal fluid pressure by means of a ventricular drainage tube were carried out duringinduction of acupuncture anesthesia or general anesthesia respectively in 18 patients with intracranialspace-occupying lesions. Recorded at the same time were the frontmastoid process rheocncephalogram andthe plethysmogram of the auricular lobule
while blood pressure at the upper arm by auscultation wasdetermined
so as to explore the possible factors that might bring an effect on the fluctuation of CSFpressure. Electro-acupuncture was applied for 20 minutes at the Jinmen and Taichong Points with the conti-nuous pulses of 80-100 Hz produced by a G-6805 electroacupuncture apparatus to induce anesthesia 0.1g of Phenobarbital and 0.3 mg of scopolamine were admin stered intramuscularly half an hour before ne-edling. General anesthesia was induced with a hyphotising doses of sodium pentothal and succinylcholi-ne (1 mg/kg body wt.). Of the acupuncture anesthesia group (6 cases) three experienced a drop in theCSF pressure
one showed no marked change while the other two had an elevated pressure of the CSF
the average being a decline of 17.0 mmH_2O. In the general anesthesia group (12 cases) all witnessed aa decrease in CSF pressure after the intra-venous administration of sodium pentothal
with an averageof 60.0 mmH_2O. While CSF pressure rose to various degrees following intra-venous administration ofsuccinylcholine
averaging 94 mmH_2O. Besides
the acupuncture anesthesia group showed an average in-crease of 3.6 mmHg of their mean arterial pressure
2.3mm average decrease of 0.11 ohm in cerebralresistance. In the general anesthesia group
the mean arterial pressure dropped on an average by 13.9mmHg
plethysmographic wave amplitude decreased by 2.5mm (average)
and cerebral resistance waslowered by an average of 0.02 obm after sodium pentothal was given i. v.
but an average elevation ofmean arterial pressure by 8.1 mmHg
an average lowering of the plethysmographic wave amplitude by1.5mm and an average increase of cerebral resistance by 0.02 ohm followed the administration of suc-cinylcholine i. v.
which postulate that the change in cerebral blood flow and the dilation and contractionof cerebral blood vessels are the primary causes that effect the rise or fall in CSF pressure.
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