脳血管撮影中の血圧の変動

-Metrizamideの有用性-

抄録

Recordings of blood pressure were obtained during cerebral angiography, and the blood pressure changes caused by injection of metrizamide and amidotrizoate meglumine were studied. Blood pressure was recorded from brachial artery during carotid angiography, and was recorded from carotid or contralateral brachial artery during retrograde brachial angiography. During carotid angiography, mean elevation of systoric pressure following injection of metrizamide and amidotrizoate meglumine were 7±9mmHg and 25±12mmHg, respectively; and mean elevation of diastoric pressure following injection of metrizamide and amidotrizoate meglumine were 4±5mmHg and 13±9mmHg, respectively. The elevation of blood pressure was statistically less following injection of metrizamide than following injection of amidotrizoate meglumine (p<0.05). During retrograde brachial angiography, blood pressure changes showed same tendency as during carotid angiography, but not showed statistical difference because of paucity of cases.
It is concluded that metrizamide has definite merit for cerebral angiography of the patient with subarachnoid hemorrhage in acute stage because of minimal blood pressure elevation.
During cerebral angiography of the patient with subarachnoid hemorrhage in acute stage, the following care should be taken.
1) use metrizamide
2) inject the least volume of contrast media under the least injection pressure
3) use sufficient analgesics and sedatives