The effect of propofol-sufentanil intravenous anesthesia on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity: a case series

Juhász, Marianna; Páll, Dénes; Fülesdi, Béla; Molnár, L.; Végh, Tamás; Molnár, Csilla

doi:10.1016/j.bjane.2021.04.002

“…General anesthesia using propofol with target-controlled infusion also maintains CA and CO 2 reactivity through a balance between vasodilation and vasoconstriction. 73 , 79 CA was unchanged in patients undergoing GA with propofol-remifentanil infusion but decreased in those receiving high-dose sevoflurane. Additionally, higher CO 2 levels did not affect CA in the propofol-remifentanil group, while the high-dose sevoflurane group experienced a further reduction in CA.…”

Section: Anesthesia and Autoregulationmentioning

confidence: 86%

Tale of Two Cities: narrative review of oxygen

Gullapalli

¹

,

Fossati

²

,

Stamenković

³

et al. 2023

F1000Res

1

0

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The human brain contributes 2% of the body weight yet receives 15% of cardiac output and demands a constant supply of oxygen (O2) and nutrients to meet its metabolic needs. Cerebral autoregulation is responsible for maintaining a constant cerebral blood flow that provides the supply of oxygen and maintains the energy storage capacity. We selected oxygen administration-related studies published between 1975–2021 that included meta-analysis, original research, commentaries, editorial, and review articles. In the present narrative review, several important aspects of the oxygen effects on brain tissues and cerebral autoregulation are discussed, as well the role of exogenous O2 administration in patients with chronic ischemic cerebrovascular disease: We aimed to revisit the utility of O2 administration in pathophysiological situations whether or not being advantageous. Indeed, a compelling clinical and experimental body of evidence questions the utility of routine oxygen administration in acute and post-recovery brain ischemia, as evident by studies in neurophysiology imaging. While O2 is still part of common clinical practice, it remains unclear whether its routine use is safe.

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“…78 General anesthesia using propofol with target-controlled infusion also maintains CA and CO 2 reactivity through a balance between vasodilation and vasoconstriction. 73,79 CA was unchanged in patients undergoing GA with propofolremifentanil infusion but decreased in those receiving high-dose sevoflurane. Additionally, higher CO 2 levels did not affect CA in the propofol-remifentanil group, while the high-dose sevoflurane group experienced a further reduction in CA.…”

Section: Anesthesia-induced Neurotoxicitymentioning

confidence: 88%

Tale of Two Cities: narrative review of oxygen

Gullapalli

¹

,

Fossati²,

Stamenković³

et al. 2023

F1000Res

0

View full text Add to dashboard Cite

The human brain contributes 2% of the body weight yet receives 15% of cardiac output and demands a constant supply of oxygen (O2) and nutrients to meet its metabolic needs. Cerebral autoregulation is responsible for maintaining a constant cerebral blood flow that provides the supply of oxygen and maintains the energy storage capacity. We selected oxygen administration-related studies published between 1975–2021 that included meta-analysis, original research, commentaries, editorial, and review articles. In the present narrative review, several important aspects of the oxygen effects on brain tissues and cerebral autoregulation are discussed, as well the role of exogenous O2 administration in patients with chronic ischemic cerebrovascular disease: We aimed to revisit the utility of O2 administration in pathophysiological situations whether or not being advantageous. Indeed, a compelling clinical and experimental body of evidence questions the utility of routine oxygen administration in acute and post-recovery brain ischemia, as evident by studies in neurophysiology imaging. While O2 is still part of common clinical practice, it remains unclear whether its routine use is safe.

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“…This might have generated a higher risk of reporting cerebral hypoperfusion, considering that Vm of the middle cerebral artery in healthy subjects is around 60 cm s −1 . 8 , 5 , 6 , 7 In fact, several studies have evaluated the effect of anaesthesia maintenance with propofol on Vm 5 , 6 and also the effect of anaesthesia induction with sevoflurane. 7 They have all reported a decrease in Vm in relation to its basal value but never lower than 40 cm s −1 .…”

mentioning

confidence: 99%