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Titolo:
Clonidine associated with benzodiazepine before carotid endarterectomy decreases cerebrovascular CO2 reactivity.
Autore:
Laffon, M; Sauvagnac, X; Ferrandiere, M; Jaber, W; Gautier, T; Martinez, R; Mercier, C; Fusciardi, J;
Indirizzi:
Hop Bretonneau, Serv Anesthesie Reanimat, F-37000 Tours, France Hop Bretonneau Tours France F-37000 esie Reanimat, F-37000 Tours, France
Titolo Testata:
ANNALES FRANCAISES D ANESTHESIE ET DE REANIMATION
fascicolo: 7, volume: 20, anno: 2001,
pagine: 604 - 611
SICI:
0750-7658(200108)20:7<604:CAWBBC>2.0.ZU;2-5
Fonte:
ISI
Lingua:
FRE
Soggetto:
CEREBRAL BLOOD-FLOW; CARBON-DIOXIDE; TRANSCRANIAL DOPPLER; MYOCARDIAL-ISCHEMIA; LOCUS COERULEUS; VELOCITY; ARTERIES; SURGERY; RECEPTORS; DEXMEDETOMIDINE;
Keywords:
cerebrovascular CO2 reactivity; clonidine; flunitrazeparn; trancranial Doppler sonography;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Laffon, M Hop Bretonneau, Serv Anesthesie Reanimat, 2 Bis Blvd Tonnele, F-37000 Tours, France Hop Bretonneau 2 Bis Blvd Tonnele Tours France F-37000, France
Citazione:
M. Laffon et al., "Clonidine associated with benzodiazepine before carotid endarterectomy decreases cerebrovascular CO2 reactivity.", ANN FR A R, 20(7), 2001, pp. 604-611

Abstract

Objective: Assess cerebrovascular CO2 reactivity changes using transcranial Doppler sonography (TCD) after oral premedication associating clonidine (2 mug.kg(-1)) and flunk trazepam (70 mug.kg(-1)) in patients scheduled for carotid stenosis surgery. Study design: Prospective study, not randomized, the patient being his own"control". Patients and methods: Thirteen patients undergoing carotid endarterectomy under cervical plexus block were included. The monitoring included: automated arterial pressure cuff, ECG, radial artery catheter, TCD with probe secured in temporal window. The study of the cerebrovascular CO2 reactivity wasperformed with TCD recording on the side of operation, on the day before, and on the day of carotid endarterectomy, 90 min after the premedication, immediately before surgery. To change PaCO2, four ventilatory states were successively performed : (1) normoventilation, (2) hyperventilation, (3) hypoventilation, (4) "breath-holding test". At each state, it was noted : HR, MAP, PaCO2, mean blood flow velocity in the middle cerebral artery (Vm-MCA),resistance index of Pourcelot (RI), cerebrovascular reactivity (slope Vm-MCA / PaCO2). The results (+/- SEM) were analyzed by Wilcoxon test or t test. Results: After premedication, cerebrovascular CO2 reactivity decreased (0.043 +/- 0.019 vs 0.034 +/- 0.013; p < 0.05) without modification of RI (0.578 +/- 0.291 vs 0.612 +/- 0.025; NS). No complication during carotid clamping was reported. Conclusion: Inclusion of clonidine in premedication before carotid stenosis surgery must be questioned because a decrease of cerebrovascular CO2 reactivity could be deleterious in case of intraoperative stroke. (C) 2001 Editions scientifiques et medicales Elsevier SAS.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/04/20 alle ore 11:09:43