Relationship Between Regional Cerebral Blood Flow and Electrocorticographic Activities Under Sevoflurane and Isoflurane Anesthesia

Abstract

The aims of this study are (1) to assess the effects of volatile anesthetics on regional cerebral blood flow (rCBF) and electrocorticography (ECoG), and (2) to investigate the relationship between rCBF and ECoG influenced by volatile anesthetics. The authors measured rCBF using laser Doppler flowmetry and ECoG simultaneously and continuously from the same cortex during craniotomy, using the specially arranged probe. Patients received intravenous anesthetics with nitrous oxide until craniotomy, and after opening of dura, volatile anesthetic, either isoflurane or sevoflurane, was started and was gradually increased for the measurement. Four of the nine cases (44.4%) of the sevoflurane group showed no change both in rCBF and ECoG. In three cases (33.3%), rCBF increased as the frequency of the paroxysmal activities increased. In two cases (22.2%), decreased rCBF was accompanied by slow waves. In 12 cases of the isoflurane group, no apparent rCBF and ECoG changes were seen, except a case with decreased rCBF and slow waves. This is the first report of simultaneous recordings of regional CBF and neuronal activity under general anesthesia. During sevoflurane and isoflurane anesthesia <2.5 minimum alveolar anesthetic concentration, rCBF is affected by ECoG activities rather than pharmacologic action of inhalational anesthetics.

Volatile Anesthetics Influence Blood-Brain Barrier Integrity by Modulation of Tight Junction Protein Expression in Traumatic Brain Injury

“…Sevoflurane has been reported to decrease CBF in a dose dependent manner in pigs [38] in contrast to data on isoflurane reported by the same group [39]. On the contrary sevoflurane and isoflurane have been shown to have similar effects on CBF in animals and humans [22], [40], [41]. Therefore, the vasodilatory effects of these anesthetics cannot explain the observed differences in this study.…”

Cerebral Hyperperfusion Syndrome Associated With Non-convulsive Status Epilepticus Following Superficial Temporal Artery-Middle Cerebral Artery Anastomosis -Case Report-

“…2,16,20) Epileptic activity causes increased metabolic demand in the involved cortex, which is accompanied by temporarily increased regional cerebral perfusion. 6,8) Since PLEDs are one of the EEG patterns in patients with NCSE, 2,9) the pathophysiology of``ictal'' hyperperfusion could be similar to that observed in our case.…”

Nonconvulsive Status Epilepticus During Perioperative Period of Cerebrovascular Surgery

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