Local cerebral blood flow with prostaglandin E1 or trimethaphan during cerebral aneurysm clip ligation
| Autor: | Toshisuke Sakaki, Kazuo Abe, Ikuto Yoshiya, Kitaro Kamada, Akira Demizu, Tetsuya Morimoto |
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| Rok vydání: | 1991 |
| Předmět: |
Adult
Male Hemodynamics Hypotension Controlled Humans Medicine Alprostadil Aged Aged 80 and over business.industry Glasgow Outcome Scale Neuroleptanalgesia Intracranial Aneurysm Vasospasm General Medicine Blood flow Middle Aged medicine.disease Anesthesiology and Pain Medicine Mean blood pressure Cerebral blood flow Cerebrovascular Circulation Anesthesia Trimethaphan Trimetaphan camsilate Female lipids (amino acids peptides and proteins) business circulatory and respiratory physiology medicine.drug |
| Zdroj: | Canadian Journal of Anaesthesia. 38:831-836 |
| ISSN: | 1496-8975 0832-610X |
| DOI: | 10.1007/bf03036956 |
| Popis: | This study was performed to examine changes in local cerebral blood flow during hypotensive anaesthesia with either prostaglandin E1 (PGE1) or trimethaphan (TMP). Local cerebral blood flow (LCBF), mean blood pressure (MBP), heart rate (HR), and hourly urine output (UO) were studied in 51 patients undergoing cerebral aneurysm surgery with neuroleptanalgesia (NLA). The incidence of vasospasm after aneurysm surgery, and outcome (Glasgow Outcome Scale) at discharge were evaluated. Measurements of LCBF were made using a thermal gradient blood flow meter. The dose of PGE1 or TMP was adjusted to maintain MBP at about 70 mmHg, and LCBF was studied during and after PGE1 or TMP administration. Hypotensive drugs were discontinued at the completion of aneurysm clipping. After starting PGE1 or TMP, MBP decreased immediately, but HR did not change in either group. The LCBF decreased 30 min after the start of TMP administration and increased immediately after its discontinuation, whereas PGE1 did not affect LCBF. Urine output increased during PGE1 administration but was unchanged during TMP. Neither drug affected surgical outcome or the incidence of vasospasm. These results suggest that PGE1 may be preferable to trimethaphan for hypotensive anaesthesia in cerebral aneurysm surgery because LCBF is maintained. |
| Databáze: | OpenAIRE |
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