Changes of Blood Flow in Internal Carotid and Vertebral Artery during Preincision Hypotension in School-Age Children
- VernacularTitle:学龄期儿童发生切皮前低血压时颈内动脉和椎动脉的血流变化
- Author:
Haohong SHI
1
;
Xuan WANG
;
Biao ZHU
Author Information
1. 复旦大学附属儿科医院麻醉科
- Keywords:
Preincision hypotension;
Internal carotid artery;
Vertebral artery;
Cerebral blood flow;
School-age children
- From:
Chinese Journal of Clinical Medicine
2015;(1):80-82
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the cerebral blood flow during preincision hypotension (PIH ) in school‐age children by measuring the changes of blood flow in main supplying artery of right hemisphere such as internal carotid and vertebral artery . Methods :A total of 44 children ,aged 7‐13 years ,with American Society of Anesthesiology (ASA ) gradeⅠ‐Ⅱ ,who were scheduled for elective surgery ,were enrolled in this study .Patients with baseline hypotension ,cardiovascular diseases and cerebrovascular diseases were excluded .Heart rate ,systolic blood pressure ,mean arterial pressure ,pulse oxygen saturation were continuously monitored during the procedure .General anesthesia was induced with propofol 2 .5 mg/kg ,fentanyl 2 μg/kg , and rocuronium 0 .6 mg/kg .After intubation ,mechanical ventilation were used to control the breath .The patients received 1 minimum alveolar concentration(MAC) sevoflurane for maintaining the anestheia ,and the end tidal CO2 partial pressure was adjusted to 35‐40 mmHg .The change of blood flow in internal carotid and vertebral artery was evaluated by detecting the time averaged velocity and diameter with Doppler ultrasound .Blood flow index was measured before induction and at the time of PIH .Results:When PIH occurred ,in right side internal carotid artery ,the diameter reduced ,the time averaged velocity and the blood flow decreased ,and the resistance index increased(P<0 .01) .Meanwhile ,in vertebral artery ,the diameter restored (P>0 .05) ,the peak systolic velocity and the time averaged velocity decreased ,the blood flow reduced ,and the resistance index increased (P<0 .01) .The cerebral flow of right side decreased(P< 0 .01) ,and the internal carotid artery percentage contribution reduced(P<0 .01) .Conclusions :When PIH occurs in school‐age children ,although the mean arterial pressure is above the lower limit of autoregulation ,the blood flow of right side internal carotid and vertebral artery significantly decreases , and the cerebral flow of right side also decreases .
