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Cerebrovascular response to carbon dioxide during sodium nitroprusside- and isoflurane-induced hypotension

Autor: MATTA, B.F., LAM, A.M., MAYBERG, T.S., ENG, C.C., STREBEL, S.
Zdroj: British journal of anaesthesia : BJA; March 1995, Vol. 74 Issue: 3 p296-300, 5p
Abstrakt: We have examined the cerebrovascular response to carbon dioxide during normotension, sodium nitroprusside (SNP)-induced hypotension and high dose isoflurane-induced hypotension in 10 patients who received a standardized general anaesthetic. Carbon dioxide reactivity was determined by varying Paco2between 3.0 and 8.0 kPa and recording simultaneously blood flow velocity from the middle cerebral artery (vmca). The paired vmca-Paco2data were analysed using linear regression to determine carbon dioxide reactivity. During hypotension, both high-dose isoflurane and SNP reduced significantly mean absolute (from 17.4 (SEM 2.3) to 13.0 (1.7) and 8.8 (1.3) cm s−1kPa−1respectively; P< 0.05) and relative (from 32.5 (3.8) to 23.6 (2.0) and 15.5 (1.3) % kPa−respectively; P< 0.05) cerebrovascular reactivity to carbon dioxide. This reduction was greater during SNP-induced hypotension (P< 0.05). We conclude that cerebrovascular reactivity to carbon dioxide was attenuated during isoflurane and SNP-induced hypotension, and that it was better preserved during isoflurane-induced hypotension. (Br. J. Anaesth. 1995; 74: 296–300)
Databáze: Supplemental Index
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