Effects of Sevoflurane on Cerebral Circulation and Metabolism in Patients with Ischemic Cerebrovascular Disease
| Autor: | Katsuyasu Kitaguchi, Hisatoshi Ohsumi, Masakazu Kuro, Toshito Nakajima, Yukio Hayashi |
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| Rok vydání: | 1993 |
| Předmět: |
Adult
Male Methyl Ethers Mean arterial pressure Minimum alveolar concentration Partial Pressure Ischemia Hemodynamics Blood Pressure Cerebral autoregulation Sevoflurane Brain Ischemia Cerebral circulation Humans Medicine Anesthesia Anesthetics business.industry Brain Carbon Dioxide Middle Aged medicine.disease Oxygen Anesthesiology and Pain Medicine Cerebral blood flow Cerebrovascular Circulation Female business Ethers circulatory and respiratory physiology medicine.drug |
| Zdroj: | Anesthesiology. 79:704-709 |
| ISSN: | 0003-3022 |
| DOI: | 10.1097/00000542-199310000-00011 |
| Popis: | Background Sevoflurane is a newly developed volatile anesthetic that has a low blood-gas partition coefficient. The effects of sevoflurane on the cerebral circulation or metabolism in humans have not been studied. The authors examined the cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRo2) during sevoflurane anesthesia. The carbon dioxide response and autoregulation of cerebral circulation were also examined. Methods Ten patients with ischemic cerebrovascular disease undergoing extraintracranial artery anastomosis were studied. Cerebral blood flow and CMRo2 were determined by the Kety-Schmidt method using argon. These procedures were performed during the Inhalation of 33% N2O, 33% argon, and oxygen with 1.5% sevoflurane (0.88 minimum alveolar concentration). To examine the relationship of CBF to a change in Paco2, CBF was measured repeatedly at steady state Paco2 of 40, 35, and 45 mmHg. Furthermore, CBF was measured before and after an increase in mean arterial pressure (MAP) caused by Intravenous infusion of methoxamine to determine the relationship between CBF and MAP. Results Cerebral blood flow and CMRo2 were 28 ± 4 ml · 100 g−1 · min−1 and 1.34 ± 0.23 ml · 100 g−1 · min−1, respectively. Cerebral blood flow was found to vary directly with Paco2 alteration. The slope of the regression line between Paco2 and CBF was 1.29 ml · 100 g−1 · min−1 · mmHg−1. On the other hand, CBF was constant throughout the elevation of MAP with vaso-pressor. Conclusions Both carbon dioxide response and cerebral autoregulation were well maintained under 0.88 MAC sevoflurane anesthesia in patients with ischemic cerebrovascular disease. |
| Databáze: | OpenAIRE |
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