氟醚静脉麻醉脊髓血流量的变化.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,*,Spinal Cord Blood Flow Change by Intravenous MidazolamDuring Isoflurane Anesthesia,Tomoki Nishiyama,MD,PhD,By Corallibra,Background,Midazolam has been used for general anesthesia and sedation during local anesthesia or artificial ventilation.,It has become clear that midazolam has an analgesic property mediated by GABA receptors in the spinal cord.Therefore,it is important to know the effects of midazolam on spinal cord blood flow.,Methods,32Cats(male;2.5-3.5Kg;12h),Isoflurane(4%)in 100%oxygen,Isoflurane(1%)in 40%oxygen,End-tidal carbon dioxide tension,Between 30 and 40 mmHg,anesthesia,maintain,ventilation,Methods,Monitor,Mesured,5,15,30,60,90,120 min,midazolam 0,1,2,or 4 mg/Kg,Heart rate,Arterial blood gas analysis,Temperature,37.00.5,Midline skin incision,L1-5 were removed,and the spinal cord was exposed.,A platinum was inserted stereotaxically into the spinal cord to a depth of 1 mm at 2 mm lateral to the midline at L2.,Spinal cord blood flow was measured eith the hydrogen clearance method.,Statistical analysis was performed with repeated-measures analysis of variance,Results,Arterial blood gas values before the study drug treatment without any difference.,Arterial blood pressure decreased during the first 30 min after MID 2 and 4mg/Kg,Heart rate did not change.,Results,Spinal cord blood flow increased significantly for 90 min after MID 1 mg/Kg and for 15 min after MID 2mg/Kg.,Discussion,Spinal cord blood flow was increased by the smallest dose of IV midazolam used(1 mg/kg)without any changes in arterial blood pressure,The largest dose(4 mg/kg)did not induce any changes in spinal cord blood flow but decreased arterial blood pressure,Discussion,Isoflurane increased spinal cord blood flow within the arterial blood pressure range of 90130mmHg,The decrease in arterial blood pressure in the midazolam 2 and 4 mg/kg groups may have decreased spinal cord blood flow during isoflurane anesthesia that masked the increase otherwise caused by midazolam,Discussion,However,in patients,midazolam is often coadministered with other anesthetics,To know the effects of midazolam,isoflurane should be discontinued,Conclusion,A smaller dose of midazolam(1 mg/kg)increased spinal cord blood flow without changes in arterial blood pressure,but a larger dose(4 mg/kg)did not change spinal cord blood flow,This was associated with a substantial arterial blood pressure decrease during isoflurane anesthesia,Thanks,