A comparison of propofol and sevoflurane anaesthesia: effects on aortic blood flow velocity and middle cerebral artery blood flow velocity*

Abstract

SummaryWe compared systemic (aortic) blood flow and cerebral blood flow velocity in 30 patients randomly allocated to receive either propofol or sevoflurane anaesthesia. Cerebral blood flow velocity (CBFv) was measured in the middle cerebral artery using transcranial Doppler. Systemic blood flow velocity (SBFv) was measured in the aorta using transthoracic Doppler sonography at the level of the aortic valve. Bispectral index (BIS) was used to measure the depth of anaesthesia. Measurements were made in the awake patient and repeated during propofol or sevoflurane anaesthesia, with BIS measurements of 40-50. The effects of SBFv on CBFv were estimated by calculating the cerebral ⁄ systemic blood flow velocity-index (CsvI). A CsvI value of 100 indicating a 1 : 1 relationship between CBFv and SBFv. The results demonstrated that propofol anaesthesia produced a significantly greater reduction in CsvI than did sevoflurane anaesthesia [propofol: 60 (19); sevoflurane: 83 (16), p ¼ 0.009, t-test]. This suggests a direct reduction in CBFv independent of SBFv during propofol anaesthesia. The greater reduction of CBFv occurring during propofol anaesthesia may be due to lower cerebral metabolic demand compared with sevoflurane anaesthesia at comparable depths of anaesthesia.

The effects of sevoflurane and propofol on cerebral hemodynamics during intracranial tumors surgery under monitoring the depth of anesthesia

“…Hemodynamic properties, such as cerebrovascular reactivity for changing CO 2 concentration in blood (20,21), and the infl uence of sevofl urane and propofol on autoregulation of cerebrovascular circulation have been widely analyzed (22)(23)(24)(25)(26)(27)(28). Comparative studies investigating the effect of these anesthetics on CBF velocity were also performed; however, they included only patients without intracranial pathology (3,5,6,19,(22)(23)(24)(25)(29)(30)(31)(32). Thus, to our knowledge, this is the fi rst study comparing effects of sevofl urane and propofol on the cerebral circula- The primary aim of the present randomized clinical investigation was to compare the cerebrovascular effects of sevofl urane and propofol by means of transcranial Doppler measurements under equipotent anesthesia.…”

Propofol Requirement during Propofol and Butorphanol Anesthesia with and without Nitrous Oxide in Short Duration Intracranial Surgeries: A Bispectral Index Guided Study

“…50-60) compared to most other studies, using a lower ranges (i.e. 40-60) [5] (45-60) [7] or (40-50) [8]. However, further studies are needed to ascertain a particular BIS range for neurosurgical procedures.…”

Effects of Sevoflurane and Propofol on the Optic Nerve Sheath Diameter in Patients Undergoing Laparoscopic Gynecological Surgery: A Randomized Controlled Clinical Studies 

“…Sevo urane has a dominant effect on cerebral oxygen metabolism at a low concentration; while at medium and high concentrations, it has a direct vasodilatory effect [30]. Propofol reduces cerebral blood ow more because of its effect on reducing cerebral oxygen metabolism rather than direct vasoconstriction [31,32]. Meanwhile, the ONSD can re ect intracranial pressure in real time; however, the correlation coe cient between ONSD and intracranial pressure in previous studies was 0.660-0.820 [19,33,34].…”