Isoflurane 마취하에 경접형골 수술시 Propofol과 Thiopental의 두개내압 하강 효과

Abstract

The effects of propofol and thiopental on the intracranial pressure (ICP) were investigated in forty, male or female adult patients with transsphenoidal approach for pituitary tumors. A 7-French epidural catheter was inserted into the lumbar subarachnoid space and connected to a pressure transducer for the monitoring of ICP and the air or saline injection. And then, the inhalation anesthesia with 3%-isoflurane via mask following thiopental and metocurine was done. The mean ICPs at the preanesthetic period, 10 min after 3%-isoflurane inhalation with mask, immediately after intubation and after 5-10 ml air or saline injection were about 4, 8, 12, 16 and 30 mmHg, respectively. With the equipotent hypnotic dose of propofol (1 mg/kg)(Group I) or thipental (2 mg/kg)(Group II), the increased ICPs were diminished to the level prior to air or saline injection. Even if mean arterial pressure (MAP) with either agents were reduced significantly comparing with pre-administration values, cerebral perfusion pressure (CPP) were significantly decreased only with group I. The authors conclude that propofol could be ascertained to reduce the increased ICP as thiopental did, but propofol reduced MAP to higher degree than thiopental. Accordingly, CPP were lower with propofol than with thiopental.