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Titolo:
Subanesthetic concentration of sevoflurane increases regional cerebral blood flow more, but regional cerebral blood volume less, than subanesthetic concentration of isoflurane in human volunteers
Autore:
Lorenz, IH; Kolbitsch, C; Hormann, C; Schocke, M; Felber, S; Zschiegner, F; Hinteregger, M; Kremser, C; Pfeiffer, KP; Benzer, A;
Indirizzi:
Innsbruck Univ, Dept Anesthesia & Intens Care Med, A-6020 Innsbruck, Austria Innsbruck Univ Innsbruck Austria A-6020 e Med, A-6020 Innsbruck, Austria Innsbruck Univ, Dept Magnet Resonance Imaging, A-6020 Innsbruck, Austria Innsbruck Univ Innsbruck Austria A-6020 aging, A-6020 Innsbruck, Austria Innsbruck Univ, Dept Biostat & Documentat, A-6020 Innsbruck, Austria Innsbruck Univ Innsbruck Austria A-6020 entat, A-6020 Innsbruck, Austria
Titolo Testata:
JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY
fascicolo: 4, volume: 13, anno: 2001,
pagine: 288 - 295
SICI:
0898-4921(200110)13:4<288:SCOSIR>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSITRON-EMISSION-TOMOGRAPHY; HIGH-RESOLUTION MEASUREMENT; TRACER BOLUS PASSAGES; CAPILLARY RECRUITMENT; PROPOFOL ANESTHESIA; VALUABLE ADDITIONS; NITROUS-OXIDE; CIRCULATION; METABOLISM; DESFLURANE;
Keywords:
humans; isoflurane; regional cerebral blood flow; regional cerebral blood volume; regional mean transit time; sevoflurane;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Kolbitsch, C Innsbruck Univ, Dept Anesthesia & Intens Care Med, Anichstr 35, A-6020 Innsbruck, Austria Innsbruck Univ Anichstr 35 Innsbruck Austria A-6020 Austria
Citazione:
I.H. Lorenz et al., "Subanesthetic concentration of sevoflurane increases regional cerebral blood flow more, but regional cerebral blood volume less, than subanesthetic concentration of isoflurane in human volunteers", J NEUROS AN, 13(4), 2001, pp. 288-295

Abstract

Both sevoflurane and isoflurane are used in moderate concentrations in neuroanesthesia practice. The limiting factors for using higher concentrationsof inhalational anesthetics in patients undergoing neurosurgery a e e agents' effects on cerebral blood flow (CBF) and cerebral blood volume (CBV). In particular, an increase in CBV, which is a key determinant of intracranial pressure, may add to the neurosurgical patient's perioperative risk. To compare the effects of a subanesthetic concentration (0.4 minimum alveolar concentration) of sevoflurane or isoflurane on regional CBF (rCBF), regionalCBV (rCBV) and regional mean transit time (rMTT), contrast-enhanced magnetic resonance imaging perfusion measurements were made in spontaneously breathing human volunteers. Absolute changes in rCBF, regional CBV, and rMTT during administration of either drug in regions of interest outlined bilaterally in white and grey matter were nonparametrically (Mann-Whitney test) analyzed. Sevoflurane increased rCBF in practically all regions (absolute change, 4.44 +/- 2.87 to 61.54 +/- 2.39 mL/100g per minute) more than isoflurane did (absolute change, 12.91 +/- 2.52 to 52.67 +/- 3.32 mL/100g per minute), which decreased frontal, parietal, and white matter rCBF (absolute change, -1.12 +/- 0.59 to -14.69 +/- 3.03 mL/100g per minute). Regional CBV was higher in most regions during isoflurane administration (absolute change, 0.75 +/- 0.03 to 4.92 +/- 0.16 mL/100g) than during sevoflurane administration (absolute change, 0.05 +/- 0.14 to 3.57 +/- 0.14 mL/100g). Regional meantransit time was decreased by sevoflurane (absolute change, -0.18 +/- 0.05to -0.60 +/- 0.04 s) but increased by isoflurane (absolute change, 0.19 +/- 0.03 to 0.69 0.04 s). In summary, regional CBV was significantly lower during sevoflurane than during isoflurane administration, although sevoflurane increased rCBF more than isoflurane, which even decreased rCBF in some regions. For sevoflurane and, even more pronouncedly, for isoflurane, the observed changes in cerebral hemodynamics cannot be explained by vasodilatation alone.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 20:17:17