Document Detail


The cerebrovascular effects of adrenaline, noradrenaline and dopamine infusions under propofol and isoflurane anaesthesia in sheep.
MedLine Citation:
PMID:  12500509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Infusions of catecholamines are frequently administered to patients receiving propofol or isoflurane anaesthesia. Interactions between these drugs may affect regional circulations, such as the brain. The aim of this animal (sheep) study was to determine the effects of ramped infusions of adrenaline, noradrenaline (10, 20, 40 micrograms/min) and dopamine (10, 20, 40 micrograms/kg/min) on cerebral blood flow (CBF), intracranial pressure (ICP), cerebrovascular resistance (CVR) and cerebral metabolic rate for oxygen (CMRO2). These measurements were made under awake physiological conditions, and during continuous propofol (15 mg/min) or 2% isoflurane anaesthesia. All three catecholamines significantly and equivalently increased mean arterial pressure from baseline in a dose-dependent manner in the three cohorts (P < 0.001). In the awake cohort (n = 8), dopamine (P < 0.01) significantly increased CBF from baseline whilst adrenaline and noradrenaline did not (P > 0.05). Under propofol (n = 6) and isoflurane (n = 6), all three catecholamines significantly increased CBF (P < 0.001). Dopamine caused the greatest increase in CBF, and was associated with significant increases in ICP (awake: P < 0.001; propofol P < 0.05; isoflurane P < 0.001) and CVR (isoflurane P < 0.05). No significant changes in CMRO2 were demonstrated. Under propofol and isoflurane anaesthesia, the cerebrovascular effects of catecholamines were significantly different from the awake, physiological state, with dopamine demonstrating the most pronounced effects, particularly under propofol. Dopamine-induced hyperaemia was associated with other cerebrovascular changes. In the presence of an equivalent effect on mean arterial pressure, the exaggerated cerebrovascular effects under anaesthesia appear to be centrally mediated, possibly induced by propofol- or isoflurane-dependent changes in blood-brain barrier permeability, thereby causing a direct influence on the cerebral vasculature.
Authors:
J A Myburgh; R N Upton; C Grant; A Martinez
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  30     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-25     Completed Date:  2003-04-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  725-33     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia and Intensive Care, University of Adelaide, Adelaide, South Australia.
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MeSH Terms
Descriptor/Qualifier:
Anesthesia*
Anesthetics, Inhalation*
Anesthetics, Intravenous*
Animals
Blood Pressure / drug effects
Brain / metabolism*
Catecholamines / administration & dosage,  pharmacology*
Cerebrovascular Circulation / drug effects*
Dopamine / administration & dosage,  pharmacology
Dose-Response Relationship, Drug
Epinephrine / administration & dosage,  pharmacology
Female
Infusions, Intravenous
Intracranial Pressure / drug effects*
Isoflurane*
Norepinephrine / administration & dosage,  pharmacology
Oxygen Consumption / drug effects*
Propofol*
Sheep
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Catecholamines; 2078-54-8/Propofol; 26675-46-7/Isoflurane; 51-41-2/Norepinephrine; 51-43-4/Epinephrine

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


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