The Effect of Desflurane and Isoflurane on Cerebrospinal Fluid Pressure in Humans with Supratentorial Mass Lesions

Muzzi, Donald A.; LoSasso, Thomas; Dietz, Niki M.; Faust, Ronald J.; Cucchiara, Roy F.; Milde, Leslie Newberg

doi:10.1097/00000542-199205000-00009

Cited by 57 publications

(16 citation statements)

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“…It is, however, not known whether sevoflurane and desflurane increase ICP or reduce cerebral CPP more than isoflurane. Studies comparing these agents in adult neuroanesthesia are inconclusive (1–4). To our knowledge no studies have compared all three agents in a pediatric population.…”

mentioning

confidence: 99%

Effects of 0.5 and 1.0 MAC isoflurane, sevoflurane and desflurane on intracranial and cerebral perfusion pressures in children

Sponheim¹,

Skraastad²,

Helseth³

et al. 2003

Acta Anaesthesiol Scand

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0.5 and 1.0 MAC isoflurane, sevoflurane and desflurane in N2O all increased ICP and reduced MAP and CPP in a dose-dependent and clinically similar manner. There were no baseline dependent increases in ICP from 0 to 1.0 MAC with isoflurane or sevoflurane, but ICP increased somewhat more, although statistically insignificant, with higher baseline values in patients given desflurane. The effect of MAP on CPP is 3-4 times higher than the effect of the increases in ICP on CPP and this makes MAP the most important factor in preserving CPP. In children with known increased ICP, intravenous anesthesia may be safer. However, maintaining MAP remains the most important determinant of a safe CPP.

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mentioning

confidence: 99%

Effects of 0.5 and 1.0 MAC isoflurane, sevoflurane and desflurane on intracranial and cerebral perfusion pressures in children

Sponheim¹,

Skraastad²,

Helseth³

et al. 2003

Acta Anaesthesiol Scand

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“…A low correlation of changes in ET desflurane and ICP seems to be an additional argument confirming this thesis. Several studies have assessed the effect of desflurane on intracranial homeostasis using CBF [20][21][22][23][24] and lumbar cerebral fluid pressure (LCSFP) [25][26][27][28] measurements.…”

Section: Discussionmentioning

confidence: 99%

“…A study analysing the effects of 1.1 MAC desflurane in patients with intracranial proliferative processes has demonstrated an increase in LCSEP [25]. In the study, the volatile anaesthetic was used in the oxygen-air mixture.…”

Section: Discussionmentioning

confidence: 99%

Wpływ stopniowo narastających stężeń desfluranu na mózgowe ciśnienie perfuzyjne u królika

Wierzchowska¹,

Kowiański²,

Niewiadomski³

et al. 2018

Anaesthesiol Intensive Ther

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Background: In nearly all cases of general anaesthesia with a volatile agent, the anaesthetic concentration has to be increased. Since the anaesthetic affects both the factors determining intracranial homeostasis and the systemic circulation, it is crucial that cerebral perfusion pressure (CPP) is protected. The aim of the present study was to assess the influence of gradually increased concentrations of desflurane on the cerebral and systemic circulations based on CPP, mean arterial pressure (MAP), intracranial pressure (ICP) and their correlations. Methods: The study was carried out on 25 rabbits of the same gender (male) randomly assigned to two groups: control (n = 10) and group I (n = 15). Over three 15-minute periods, the animals were exposed to increase concentrations of desflurane so as to achieve 1/3, 2/3 and 1 MAC Minimal Alveolar Concentration (3, 6, 9 vol%) of the effective end-tidal concentration of desflurane (Et) at the end of each period, respectively. Conclusions: A decrease in CPP induced by desflurane was associated with a decrease in MAP but not an increase in ICP. The depressive effect of desflurane on the cerebral and systemic circulations is a consequence of its effector site concentration.

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“…4 Ornstein et al 5 studied human cerebral blood flow data in patients with intracranial mass lesions and reported that, under hypocapnic conditions, cerebral blood flow remained stable during isoflurane and desflurane anesthesia, and cerebrovascular reactivity to CO 2 was preserved with both agents. 4 Ornstein et al 5 studied human cerebral blood flow data in patients with intracranial mass lesions and reported that, under hypocapnic conditions, cerebral blood flow remained stable during isoflurane and desflurane anesthesia, and cerebrovascular reactivity to CO 2 was preserved with both agents.…”

Section: Commentmentioning

confidence: 99%

The Comparative Effects of Desflurane and Isoflurane on Lumbar Cerebrospinal Fluid Pressure in Patients Undergoing Craniotomy for Supratentorial Tumors

Contreras¹,

Cunningham²

2005

Survey of Anesthesiology

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C erebral vasospasm continues to be a leading cause of morbidity and mortality after subarachnoid hemorrhage (SAH). Cerebral ischemia may ensue when autoregulation fails to compensate for spasm. How autoregulation is affected by vasospasm was examined using transcranial Doppler (TCD). The moving correlation coefficient between slow changes of arterial blood pressure and mean or systolic flow velocity, termed ''Mx'' and ''Sx,'' respectively, was used to characterize cerebral autoregulation. Vasospasm was declared when the mean flow velocity increased to more 120 cm/s and the Lindegaard ratio was more than 3. This occurred in 15 of 32 SAH patients. Based on the bilateral TCD recordings of the middle cerebral artery in vasospastic patients, Mx and Sx were calculated for baseline and vasospasm. Mx increased during vasospasm (0.46 ± 0.32; mean ± SD) and was markedly higher than at baseline (0.21 ± 0.24). Sx was also increased (0.22 ± 0.26 vs. 0.05 ± 0.21 at baseline). Mx correlated with mean flow velocity (r = 0.577) and the Lindegaard ratio (r = 0.672). Mx and Sx were higher on the vasospastic side (Mx, 0.44 ± 0.27; Sx, 0.16 ± 0.25). The increase in Mx and Sx during cerebral vasospasm demonstrated impaired cerebral autoregulation. Mx and Sx provide additional information on changes in autoregulation in SAH patients.

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The Effect of Desflurane and Isoflurane on Cerebrospinal Fluid Pressure in Humans with Supratentorial Mass Lesions

Cited by 57 publications

References 0 publications

Effects of 0.5 and 1.0 MAC isoflurane, sevoflurane and desflurane on intracranial and cerebral perfusion pressures in children

Effects of 0.5 and 1.0 MAC isoflurane, sevoflurane and desflurane on intracranial and cerebral perfusion pressures in children

Wpływ stopniowo narastających stężeń desfluranu na mózgowe ciśnienie perfuzyjne u królika

The Comparative Effects of Desflurane and Isoflurane on Lumbar Cerebrospinal Fluid Pressure in Patients Undergoing Craniotomy for Supratentorial Tumors

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