Document Detail


Effect of sevoflurane on cerebral blood flow and cerebrovascular resistance at surgical level of anaesthesia: a transcranial Doppler study.
MedLine Citation:
PMID:  16970835     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: It is widely accepted that sevoflurane affects cerebral circulation, but there are uncertainities regarding the magnitude of its effect. The aim of the present work was to assess the effect of sevoflurane on the cerebral circulation at surgical levels of anaesthesia. METHODS: Twenty patients undergoing elective lumbar discectomies were investigated. Anaesthesia was induced with propofol and maintained with sevoflurane. The level of surgical anaesthesia was determined by bispectral index, the target level was 45-55. Transcranial Doppler (TCD) measurement was performed before induction and after reaching the surgical level of anaesthesia. Besides routine parameters (middle cerebral artery mean blood flow velocity (MCAV) and pulsatility index (PI)) derived parameters (estimated cerebral perfusion pressure (eCPP), cerebral blood flow index (CBFI) and resistance area product (RAP)) were calculated by taking changes of mean arterial pressure also into account. RESULTS: MCAV decreased from 54.1 +/- 13.3 to 43.7 +/- 18.5 cm s-1, P < 0.01 and PI increased from 0.79 +/- 0.2 to 0.92 +/- 0.2, P < 0.01 after reaching the surgical level of anaesthesia. As a result eCPP decreased by 18.2%, CBFI by 25.5% and RAP increased by 15% respectively. CONCLUSIONS: Our data indicate a vasodilatory effect of sevoflurane at surgical level of anaesthesia on large cerebral vessels or a vasoconstriction of the resistance arterioles likely caused by decreased brain metabolism.
Authors:
C Molnár; G Settakis; P Sárkány; S Kálmán; S Szabó; B Fülesdi
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2006-09-14
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  24     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-04     Completed Date:  2007-04-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  179-84     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Intensive Care, Health and Medical Science Centre, University of Debrecen, Nagyerdei krt. 98, H-4012 Debrecen, Hungary.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, General / methods*
Anesthetics, Inhalation / pharmacology*
Blood Flow Velocity / drug effects
Blood Pressure / drug effects
Cerebrovascular Circulation / drug effects*
Electroencephalography / methods
Female
Heart Rate / drug effects
Humans
Lumbar Vertebrae / surgery
Male
Methyl Ethers / pharmacology*
Surgical Procedures, Elective / methods
Ultrasonography, Doppler, Transcranial / methods*
Vascular Resistance / drug effects*
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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