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Objective To study the effects of controlled hypotension with sevoflurane on hymo-dynamics and cerebral metabolic rate of oxygen in neurosurgery.Methods Thirty-seven ASA Ⅰ or Ⅱpatients undergoing elective intracranial surgery were enrolled.The patients were treated with general anesthesia and assigned to two experimental groups,sevoflurane group (group S,n=20)and sodium nitroprusside group (group N,n=1 7).HR,BP,SpO2 and ECG were continuously monitored during operation.Blood samples were taken from radial artery and internal jugular bulb to determine cerebral arteriovenous oxygen differences (Da-jvO2 ) and cerebral metabolic rate of oxygen (CMRO2 ). Results The HR in group S were decreased during hypotension,5 min,10 min,20 min,and 30 min compared with group N (P <0.05).Da-jvO2 and CMRO2 both in two groups were decreased during hypotension(P < 0.05 ),but there was no difference between the two groups.RPP was lower in group S than in group N during hypotension.Conclusion Controlled hypotension with sevoflurane does not increase HR and improves cerebral blood flow-metabolism coupling.
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Background Carotid stenosis is one of the important causes of ocular ischemic diseases,To study their relationship is helpful for us to classify and manage the ocular ischemic diseases.Objective This study was to investigate the correlation between ocular ischemic diseases and carotid stenosis.Methods Twenty patients with internal carotid artery stenosis rate more than 60％ defined by digital subtraction angiography(DSA) or magnetic resonance angiography (MRA) were selected,including 9 patients with lateral carotid artery stenosis and 11 patients with bilateral carotid artery stenosis.The best corrected visual acuity,intraocular pressure and fundus examinations were carried out,and the peak systolic velocity (PSV) and end diastolic velocity (EDV) of the central retinal artery(CRA) were detected with color doppler flowimaging (CDFI).The resistance index(RI) was calculated by the formula RI =PSV- EDV/PSV.The correlation between internal carotid artery stenosis rate and PSV or RI was evaluated by Spearman rank correlated analysis.Results The subjective inanifestations included transient amaurosis in 77.4％ frequency and visual blur in 22.6％ frequency in the 31 carotid artery stenosis.Twelve eyes(38.7％ ) appeared the ocular vascular abnormality.Other 2 patients were diagnosed as hypoperfusion retinopathy complicated by neovascular glaucoma.A negative relationship was found between internal carotid artery stenosis rate and PSV of CRA ( r =-0.41,R2 =0.168,P =0.021 ＜0.05 ),but no significant relationships was found between internal carotid artery stenosis rate and RI ( r =- 0.26,R2 =0.068,P =0.159 ).Conclusions Carotid artery stenosis can cause the of ocular ischemic symptoms.The characteristics of retinal hemodynamics is the type of low speed and normal resistance.
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Objective To explore the changes of finger artery hemodynamics of patients with pulmonary heart disease, at the same time to search for the relationship with PaO_2.Methods We used American ACUSON128/xp10 and ATL5000 color Doppler ultrasound diagnostic instrument to detect double middle - finger artery hymodynamics items; VSMANX, VDMIN,TAMX , PI and RI. We used Danish ABL5 artery blood gas analysis to monitor PaO_2 and SaO_2.Results PaO_2 ,SaO_2, VSMAX,VDMIN ,TAMX,and PI in control group,pulmonary heart disease remission stage, active attack stage had significant difference (P