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Titolo:
Propofol versus isoflurane anesthesia under hypothermic conditions: Effects on intracranial pressure and local cerebral blood flow after diffuse traumatic brain injury in the rat
Autore:
Kahveci, FS; Kahveci, N; Alkan, T; Goren, B; Korfali, E; Ozluk, K;
Indirizzi:
Uludag Univ, Sch Med, Dept Neurosurg, TR-16059 Gorukle, Bursa, Turkey Uludag Univ Gorukle Bursa Turkey TR-16059 TR-16059 Gorukle, Bursa, Turkey Uludag Univ, Sch Med, Dept Anesthesiol, Gorukle, Bursa, Turkey Uludag Univ Gorukle Bursa Turkey ept Anesthesiol, Gorukle, Bursa, Turkey Uludag Univ, Sch Med, Intens Care Unit, Gorukle, Bursa, Turkey Uludag Univ Gorukle Bursa Turkey ntens Care Unit, Gorukle, Bursa, Turkey Uludag Univ, Sch Med, Dept Physiol, Gorukle, Bursa, Turkey Uludag Univ Gorukle Bursa Turkey d, Dept Physiol, Gorukle, Bursa, Turkey
Titolo Testata:
SURGICAL NEUROLOGY
fascicolo: 3, volume: 56, anno: 2001,
pagine: 206 - 214
SICI:
0090-3019(200109)56:3<206:PVIAUH>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
GLUCOSE-UTILIZATION; MILD HYPOTHERMIA; HEAD-INJURY; HIPPOCAMPAL GLUTAMATE; MODERATE HYPOTHERMIA; ELECTRICAL-ACTIVITY; ISCHEMIA; METABOLISM; HALOTHANE; ANTIOXIDANT;
Keywords:
propofol; isoflurane; hypothermia; head injury; rat; LCBF;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
63
Recensione:
Indirizzi per estratti:
Indirizzo: Korfali, E Uludag Univ, Sch Med, Dept Neurosurg, TR-16059 Gorukle, Bursa, Turkey Uludag Univ Gorukle Bursa Turkey TR-16059 rukle, Bursa, Turkey
Citazione:
F.S. Kahveci et al., "Propofol versus isoflurane anesthesia under hypothermic conditions: Effects on intracranial pressure and local cerebral blood flow after diffuse traumatic brain injury in the rat", SURG NEUROL, 56(3), 2001, pp. 206-214

Abstract

BACKGROUND The aim of this study was to compare the cerebral protective effects of two known protective anesthetics, isoflurane and propofol, when these were used in combination with moderate hypothermia (33-34 degreesC) after diffuse traumatic brain injury (TBI) in the rat. We assessed cerebral protection by measuring local cerebral blood flow (LCBF), mean arterial bloodpressure (MABP), cerebral perfusion pressure (CPP) and intracranial pressure (ICP). METHODS Sixteen female Wistar rats weighing 275 to 350 g were anesthetizedand subjected to an accelerated-impact weight-drop model of diffuse TBI. Hypothermia (33-34 degreesC) was induced 45 minutes after TBI (baseline), and was maintained for 180 minutes. The isoflurane group (n = 8) received 70%N2O in O-2, and isoflurane at 0.9 +/- 0.04%. The propofol group (n = 8) received 70% N2O in O-2 and a propofol infusion (12 mg/kg/hr). LCBF was measured by laser Doppler flowmeter. MABP, ICP, and brain and rectal temperatures were measured every 15 minutes from baseline through 180 minutes. Blood gas and hematocrit testing was also done at baseline and every 60 minutes thereafter to assess the animals' physiological state. RESULTS In the isoflurane group, MABP and CPP decreased significantly frombaseline to 180 minutes (p <0.05 and p <0.01, respectively), and MABP was significantly lower than the pressure in the propofol group from 45 minutesthrough 180 minutes (p <0.05, p <0.01). ICP and LCBF remained unchanged inthis group. In the propofol group, from baseline to 180 minutes, CPP increased to maximum 120 +/- 8 mmHg at 75 minutes from 98 +/- 5 mmHg (p <0.05) and ICP fell from 18 +/- 2 mmHg to 7 +/- 1 mmHg (p <0.01); and the latter was significantly lower than ICP in the isoflurane group (P <0.05, p <0.01, p<0.001). LCBF in this group was significantly higher than LCBF in the isoflurane group in the last 30 minutes of the experiment (p <0.05). The propofol group showed no change in MABP over the course of the experiment. CONCLUSION In the clinical setting, propofol anesthesia may be better for use in combination with hypothermia in cases of traumatic brain injury, as it reduces ICP and increases CPP under these conditions. (C) 2001 by Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 13:04:12