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Titolo:
Effects of remifentanil/propofol in comparison with isoflurane on dynamic cerebrovascular autoregulation in humans
Autore:
Engelhard, K; Werner, C; Mollenberg, O; Kochs, E;
Indirizzi:
Tech Univ Munich, Klinikum Rechts Isar, Anasthesiol Klin, D-81675 Munich, Germany Tech Univ Munich Munich Germany D-81675 ol Klin, D-81675 Munich, Germany
Titolo Testata:
ACTA ANAESTHESIOLOGICA SCANDINAVICA
fascicolo: 8, volume: 45, anno: 2001,
pagine: 971 - 976
SICI:
0001-5172(200109)45:8<971:EORICW>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
CEREBRAL BLOOD-FLOW; AUTO-REGULATION; INTRACRANIAL-PRESSURE; PROPOFOL ANESTHESIA; ANESTHETIZED RATS; NITROUS-OXIDE; SEVOFLURANE; CIRCULATION; VELOCITY; DOGS;
Keywords:
remifentanil; propofol; isoflurane; dynamic cerebrovascular autoregulation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Engelhard, K Tech Univ Munich, Klinikum Rechts Isar, Anasthesiol Klin, Ismaninger Str 22, D-81675 Munich, Germany Tech Univ Munich Ismaninger Str 22 Munich Germany D-81675 ny
Citazione:
K. Engelhard et al., "Effects of remifentanil/propofol in comparison with isoflurane on dynamic cerebrovascular autoregulation in humans", ACT ANAE SC, 45(8), 2001, pp. 971-976

Abstract

Background: This study investigates the effects of remifentanil and propofol in comparison to isoflurane on dynamic cerebrovascular autoregulation inhumans. Methods: In 16 awake patients dynamic cerebrovascular autoregulation was measured using transcranial Doppler sonography (TCD). Thereafter patients were intubated, ventilated with O-2/air (FiO(2)=0.33) and randomly assigned to one of the following anesthetic protocols: group I (n=8): 0.5 mug . kg(-1) . min(-1) remifentanil combined with a propofol-target plasma concentration of 1.5 mug . ml(-1); group 2 (n=8): 1.8 % isoflurane (1.5 MAC). Following 20 min of equilibration the autoregulatory challenge was repeated. Arterial blood gases and body temperature were maintained constant over time. Statistics: Mann-Whitney U-test and Wilcoxon signed-rank test. Results: Dynamic autoregulation was intact in all patients prior to induction of anesthesia expressed by an autoregulatory index (ARI) of 5.4 +/- 1.21 (mean +/- SD, group 1) and 5.9 +/- 0.98 (mean +/- SD, group 2). With remifentanil/propofol anesthesia dynamic auto-regulation was similar to the awake state (group 1: ARI= 4.9 +/- 0.88). In contrast, autoregulatory responsewas delayed with 1.5 MAC isoflurane (group 2, ARI=2.1 +/- 0.92) (P <0.05). Conclusion: These data show that dynamic cerebrovascular autoregulation ismaintained with remifentanil-based total intravenous anesthesia. This is consistent with the view that narcotics (and hypnotics) do not alter the physiologic cerebrovascular responses to changes in MAP. In contrast, 1.5 MAC isoflurane delays cerebrovascular autoregulation compared to the awake state.

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Documento generato il 29/03/20 alle ore 10:48:16