The Effects of Surgical Stimulation on Intracranial Hemodynamics
作者:
Georg von Knobelsdorff,
Hiromitsu Kusagaya,
Christian Werner,
Eberhard Kochs,
Jochen am Esch,
期刊:
Journal of Neurosurgical Anesthesiology
(OVID Available online 1996)
卷期:
Volume 8,
issue 1
页码: 9-14
ISSN:0898-4921
年代: 1996
出版商: OVID
关键词: Isoflurane;Doppler, transcranial;Cerebral blood flow;Catecholamines;Surgical stimulation
数据来源: OVID
摘要:
This study investigates the effects of surgical stimulation on cerebral blood flow velocity using transcranial Doppler sonography (TCD) in 1 and 2 maximum alveolar concentration (MAC) isoflurane anesthetized patients. Sixty ASA I and II patients undergoing breast surgery were studied. Anesthesia was maintained with 0.6% isoflurane (groups 1 and 2) or 1.2% isoflurane (groups 3 and 4) and nitrous oxide in oxygen (Fio2, 0.33). TCD recordings of middle cerebral artery mean blood flow velocity (Vmean, cm/s) were taken before each respective treatment and for the 15-min investigation period. In groups 1 and 3 (eachn= 20), the patients were exposed to surgical stimulation (skin incision). In groups 2 and 4 (eachn= 10), norepinephrine infusion (0.1 μg · kg−1· min−1) was used to increase mean arterial blood pressure (MAP) to levels similar to those seen with surgical stimulation (groups 1 or 3). Body temperature and PETCO2remained constant over time and did not vary between treatment groups. In groups 1 and 3, MAP increased 22 and 16% after surgical stimulation. In groups 2 and 4, MAP increased 28 and 36% after norepinephrine infusion. Vmeanwas increased 23 and 17% after surgical stimulation during 1 and 2 MAC isoflurane but did not change with norepinephrine infusion. These data show that cerebral blood flow velocity increases with surgical stimulation in 1 and 2 MAC isoflurane-anesthetized patients. This is not a function of changes in MAP. These data suggest that surgical stimulation increases cerebral blood flow, possibly because of arousal.
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