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首页> 外文期刊>The Internet Journal of Neuromonitoring >Transcranial Monitoring of Cerebral Oxygen Saturation under Different Anesthetic Drugs and Ventilation Patterns: Observations in an Animal Model
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Transcranial Monitoring of Cerebral Oxygen Saturation under Different Anesthetic Drugs and Ventilation Patterns: Observations in an Animal Model

机译：在不同麻醉药物和通气方式下的经颅脑氧饱和度监测：在动物模型中的观察

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Background: Transcranial regional cerebral oxygen saturation (rSO2) is based on specific algorithms of near infrared spectroscopy (NIRS). In an animal model we measured the reactivity of rSO2 trends under basal total intravenous anesthesia (TIVA) with propofol and remifentanil during different experimental interventions. These maneuvers included the additional application of desflurane and halothane as well as hypo- and hyperventilation in two pigs.Results: Induced hypercapnia during administration of desflurane and halothane led to increased rSO2 values. Administration of thiopental (5mg/kg bolus followed by 3mg/kg/h continuously) under normocapnia also led to increased rSO2 values. In contrast, thiopental administration during hypocapnia led to moderately decreased rSO2 readings.Conclusion: Monitoring of cerebral oxygenation metabolism seems to be a control tool in an interventional setting using the combination of thiopental and hyperventilation. Further studies in this context using NIRS monitoring and cerebral tissue oxygenation appear warranted. Introduction Transcranial near infrared spectroscopy (NIRS) is assigned to estimate the balance of cerebral oxygen supply and cerebral oxygen consumption [12345678910111213141516]. In our animal model, we recorded cerebral regional oxygen saturation (rSO2) during various anesthesiologic conditions and maneuvers (different ventilation settings, use of volatile anesthetic agents and thiopental). The aim of this study was to detect if and how these different conditions may be reflected by changes of rSO2 values. Methods We recorded rSO2 during different maneuvers in two pigs during standardized anesthesia. The study design is shown in Fig. 1. Appropriate approval for animal experimentation was obtained (BM/BWK-66.010/36-BrgT/2006). AnesthesiaTwo pigs (sus domesticus; 30 and 34 kg, respectively) were studied. The animals were premedicated intramuscularly with diazepam (7/9 mg), azaperone (80/100 mg) and ketamine (250/450 mg) 15 minutes before placement of an intravenous line at an ear. Orotracheal intubation was performed after administration of fentanyl (2-3 mg/kg) and propofol 1% (3 mg/kg). Total intravenous anesthesia (TIVA) with 1% propofol (6 mg/kg) and remifentanil (0.08-0.1 mg/kg) and paralysis with rocuronium (0.6 mg/kg) were maintained until the end of the experiment.In addition to standardized anesthesia animal A was insufflated desflurane under hypercapnia during measurement phase I (MAC II) and animal B halothane (MAC II). During measurement phase II both animals were administered thiopental.After an initial dosage of thiopental (5 mg/kg) as bolus a continuous rate of 3 mg/kg/h was maintained (Fig. 1).Respiratory and Circulatory ManagementThe animals were ventilated with a Julian Plus? machine (Dr?ger, Lübeck, Germany) (Table 1).
机译：背景：经颅区域性脑血氧饱和度（rSO2）基于近红外光谱（NIRS）的特定算法。在动物模型中，我们测量了在不同实验干预下，基础全静脉麻醉（TIVA）下异丙酚和瑞芬太尼对rSO2趋势的反应性。这些措施包括在两只猪中额外添加地氟醚和氟烷以及通风不足和过度换气。结果：在地氟醚和氟烷的给药过程中诱导的高碳酸血症导致rSO2值升高。在正常碳酸血症下给予硫喷妥钠（5mg / kg推注，然后连续3mg / kg / h）也导致rSO2值升高。相比之下，在低碳酸血症期间使用硫喷妥钠导致rSO2读数适度下降。结论：在使用硫喷妥钠和过度换气的干预性环境中，监测脑氧合代谢似乎是一种控制工具。在这种情况下，使用NIRS监测和脑组织氧合的进一步研究看来是必要的。引言经颅近红外光谱法（NIRS）用于估计脑供氧和脑耗氧的平衡[12345678910111213141516]。在我们的动物模型中，我们记录了各种麻醉条件和操作（不同的通气设置，使用挥发性麻醉剂和硫喷妥钠）期间的大脑局部氧饱和度（rSO2）。这项研究的目的是检测rSO2值的变化是否以及如何反映这些不同的条件。方法我们在标准化麻醉过程中记录了两只猪在不同操作过程中的rSO2。研究设计如图1所示。已获得动物实验的适当批准（BM / BWK-66.010 / 36-BrgT / 2006）。麻醉研究了两只猪（家养;分别为30和34kg）。在将静脉输液管置入耳朵前15分钟，对动物进行了地西m（7/9 mg），氮杂哌酮（80/100 mg）和氯胺酮（250/450 mg）的肌肉内药物治疗。给予芬太尼（2-3 mg / kg）和异丙酚1％（3 mg / kg）后进行气管插管。维持全静脉麻醉（TIVA）和1％异丙酚（6 mg / kg）和瑞芬太尼（0.08-0.1 mg / kg）并用罗库溴铵（0.6 mg / kg）麻痹直至试验结束。在测量阶段I（MAC II）和动物B氟烷（MAC II）中，动物A在高碳酸血症下被注入了地氟醚。在第二阶段的测量中，两只动物都注射了硫喷妥钠，在初始剂量的硫喷妥钠（5 mg / kg）推注后，维持了3 mg / kg / h的连续速率（图1）。呼吸和循环管理朱利安Plus？机器（德国吕贝克Dr？ger）（表1）。

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