The Effects of Sevoflurane on Cerebral Hemodynamics During Propofol Anesthesia

Heath, Karen; Gupta, Sanjeeva; Matta, Basil F.

doi:10.1213/00000539-199712000-00019

Cited by 47 publications

(18 citation statements)

References 20 publications

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“…When the cerebral metabolic rate is already depressed, sevo¯urane increases CBF by vasodilation. As a single agent anaesthetic, sevo¯urane decreases the cerebral metabolic rate of oxygen (CMRO 2 ) and CBF [6]. This theory is supported by our ®ndings, because the reduction of CBFv under iso¯urane and sevo¯urane as single agent anaesthetics may be due to a decreased CMRO 2 at all three concentrations.…”

Section: Discussionsupporting

confidence: 83%

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Influence of aortic blood flow velocity on changes of middle cerebral artery blood flow velocity during isoflurane and sevoflurane anaesthesia

Holzer¹,

Greher²,

Hetz³

et al. 2001

European Journal of Anaesthesiology

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Background and objective We studied the in¯uence of systemic (aortic) blood¯ow velocity on changes of cerebral blood¯ow velocity under iso¯urane or sevourane anaesthesia. Methods Forty patients (age: iso¯urane 24±62 years; sevo¯urane 24±61 years; ASA I±III) requiring general anaesthesia undergoing routine spinal surgery were randomly assigned to either group. Cerebral blood ow velocity was measured in the middle cerebral artery by transcranial Doppler sonography (depth: 50±60 mm). Systemic blood¯ow velocity was determined by transthoracic Doppler sonography at the aortic valve. Heart rate, arterial pressure, arterial oxygen saturation and body temperature were monitored. After standardized anaesthesia induction (propofol, remifentanil, vecuronium) sevo¯urane or iso¯urane were used as single agent anaesthetics. Cerebral blood¯ow velocity and systemic blood¯ow velocity were measured in the awake patient (baseline) and repeated 5 min after reaching a steady state of inspiratory and end-expiratory concentrations of 0.75, 1.00, and 1.25 mean alveolar concentrations of either anaesthetic. To calculate the in¯uence of systemic blood ow velocity on cerebral blood¯ow velocity, we de®ned the cerebral±systemic blood¯ow velocity index (CSvI). CSvI of 100% indicates a 1:1 relationship of changes of cerebral blood¯ow velocity and systemic blood¯ow velocity. Results Iso¯urane and sevo¯urane reduced both cerebral blood¯ow velocity and systemic blood¯ow velocity. The CSvI decreased signi®cantly at all three concentrations vs. 100% (iso¯urane/sevo¯urane: 0.75 MAC: 85 AE 25%/81 AE 23%, 1.0 MAC: 79 AE 19%/74 AE 16%, 1.25 MAC: 71 AE 16%/79 AE 21%; [mean AESD] P 0.0001). Conclusions The reduction of the CSvI vs. 100% indicates a direct reduction of cerebral blood¯ow velocity caused by iso¯urane/sevo¯urane, independently of systemic blood¯ow velocity.

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Section: Discussionsupporting

confidence: 83%

“…In our patients, sevo¯urane reduces CBFv compared with the awake patient. Heath and his colleagues reported reduced brain oxygen consumption without effect on CBFv under the in¯uence of large dose sevourane during propofol anaesthesia [6]. When the cerebral metabolic rate is already depressed, sevo¯urane increases CBF by vasodilation.…”

Section: Discussionmentioning

confidence: 99%

Influence of aortic blood flow velocity on changes of middle cerebral artery blood flow velocity during isoflurane and sevoflurane anaesthesia

Holzer¹,

Greher²,

Hetz³

et al. 2001

European Journal of Anaesthesiology

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“…It has the least intrinsic cerebral vasodilatory effect of the volatile agents, 1,2 and maintains the CBF velocity constant with increasing MAC in both children and adults. 3,4 Autoregulation, ICP and cerebrovascular reactivity to carbon dioxide are maintained. [5][6][7] Although the effects of sevoflurane on CBF and its response to changes in PaCO 2 have been studied clinically as well as experimentally, it is still unclear whether the hypocapnia-induced decrease in CBF is a non-specific and general effect on the brain or rather linked to specific brain regions.…”

mentioning

confidence: 99%

Regional cerebral blood flow responses to hyperventilation during sevoflurane anaesthesia studied with PET

Schlünzen¹,

Vafaee

Juul³

et al. 2010

Acta Anaesthesiol Scand

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“…SBFv can be measured easily and noninvasively by transthoracic insonation of the aorta in the five‐chamber view with a pulse wave Doppler [17,18]. It has been demonstrated that CBF and CBFv are changed under the influence of isoflurane and sevoflurane [5–8,20,21]. It has not been investigated whether the reported relative changes of CBFv under the influence of volatile anaesthetics correlate with relative changes in SBFv.…”

Section: Discussionmentioning

confidence: 99%

“…Effects of volatile anaesthetics on CBFv are well documented [1,5–8]. In addition, effects of volatile anaesthetics on the cardiovascular system have been investigated [9].…”

Section: Introductionmentioning

confidence: 99%

Influence of aortic blood flow velocity on changes of middle cerebral artery blood flow velocity during isoflurane and sevoflurane anaesthesia

Holzer

Greher²,

Hetz³

et al. 2001

Eur J Anaesthesiol

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The Effects of Sevoflurane on Cerebral Hemodynamics During Propofol Anesthesia

Cited by 47 publications

References 20 publications

Influence of aortic blood flow velocity on changes of middle cerebral artery blood flow velocity during isoflurane and sevoflurane anaesthesia

Influence of aortic blood flow velocity on changes of middle cerebral artery blood flow velocity during isoflurane and sevoflurane anaesthesia

Regional cerebral blood flow responses to hyperventilation during sevoflurane anaesthesia studied with PET

Influence of aortic blood flow velocity on changes of middle cerebral artery blood flow velocity during isoflurane and sevoflurane anaesthesia

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