Transcranial doppler sonography: nitrous oxide and cerebral blood flow velocity in children

Leon, Jeffrey E.; Bissonnette, Bruno

doi:10.1007/bf03008614

Cited by 19 publications

(21 citation statements)

References 30 publications

(5 reference statements)

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“…This is in contrast to the global cerebral vasodilatation produced by CO 2 (46,47). The exact mechanism behind this cerebral vasodilatation is not known, however, mitochondrial activation (46,53,54,58,59), and sympathoadrenal stimulation (60,61) have been suggested. According to the experimental data, N 2 O increases CMRO 2 when given alone (62) or in combination (63-65) with other anesthetic drugs.…”

Section: Pharmacologymentioning

confidence: 95%

“…More specifically, N 2 O increases regional CBF and regional CBV in supratentorial grey matter. This is in contrast to the global cerebral vasodilatation produced by CO 2 (46,47). The exact mechanism behind this cerebral vasodilatation is not known, however, mitochondrial activation (46,53,54,58,59), and sympathoadrenal stimulation (60,61) have been suggested.…”

mentioning

confidence: 87%

“…Volatile anesthetic agents Nitrous oxide. Nitrous oxide is a cerebrovasodilator when used alone (46)(47)(48)(49) or as an adjunct to volatile agents (50)(51)(52)(53)(54)(55) or propofol (56,57) in both adults, and children. More specifically, N 2 O increases regional CBF and regional CBV in supratentorial grey matter.…”

Section: Pharmacologymentioning

confidence: 99%

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Impact of anesthetic agents on cerebrovascular physiology in children

Szabó

Luginbuehl

Bissonnette

2009

Pediatric Anesthesia

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The role of the pediatric neuroanesthetist is to provide comprehensive care to children with neurologic pathologies. The cerebral physiology is influenced by the developmental stage of the child. The understanding of the effects of anesthetic agents on the physiology of cerebral vasculature in the pediatric population has significantly increased in the past decade allowing a more rationale decision making in anesthesia management. Although no single anesthetic technique can be recommended, sound knowledge of the principles of cerebral physiology and anesthetic neuropharmacology will facilitate the care of pediatric neurosurgical patients.

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Section: Pharmacologymentioning

confidence: 95%

mentioning

confidence: 87%

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Impact of anesthetic agents on cerebrovascular physiology in children

Szabó

Luginbuehl

Bissonnette

2009

Pediatric Anesthesia

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“…These results correspond well with earlier CBF and cerebral blood flow velocity measurements which showed that equipotent doses of different inhalation anaesthetics, ranging up to 1 MAC in oxygen/air, comparably affect cerebral perfusion. Distinct effects on cerebral perfusion were found when patients received different inhalational anaesthetics in higher doses (> 1 MAC) and especially when nitrous oxide is given simultaneously [23–27]. Thiel et al .…”

Section: Discussionmentioning

confidence: 99%

“…Volatile anaesthetics such as halothane, isoflurane, or even nitrous oxide can also influence cerebrovascular resistance and vascular tone. Comparative studies have shown that these anaesthetics can induce totally different substance‐specific and dose‐dependent changes in cerebral circulation during general anaesthesia [23–28]. Human clinical investigations on the potential interactive effects of theophylline and volatile anaesthetics on cerebral perfusion during general anaesthesia have not yet been published.…”

Section: Introductionmentioning

confidence: 99%

Effects of theophylline on human cerebral blood flow velocity during halothane and isoflurane anaesthesia

et al. 1999

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The acute influence of therapeutic doses of theophylline on cerebral blood flow velocities during general anaesthesia induced either by halothane or isoflurane has not been elucidated previously. The aim of this study, was therefore to investigate these effects during steady state anaesthetic conditions in anaesthetized patients using transcranial Doppler sonography. Thirty-four Patients were investigated. Anaesthesia was maintained either with 1 MAC (minimum alveolar concentration) halothane (n = 16) or 1 MAC isoflurane (n = 18); FiO2: 40%; end-expiratory pCO2: normocapnia. Theophylline administration was performed before surgery by infusing 6 mg kg-1 over a period of 7.5 min. Measurements were recorded prior to theophylline administration, and immediately after 2 mg kg-1 (2.5 min), 4 mg kg-1 (5 min) and 6 mg kg-1 (7.5 min), as well as 5, 10, 15, 20, 30 and 45 min after theophylline administration. Recorded variables included blood pressure, heart rate, arterial oxygen saturation, end-expiratory pCO2, body temperatures, middle cerebral artery blood flow velocity and pulsatility index. Theophylline administration was well tolerated by all study subjects. Heart rate, blood pressure, body temperatures, arterial oxygen saturation and end-expiratory pCO2 remained constant during the whole examination period. Following theophylline, mean blood flow velocity decreased by 25% in the halothane and by 30% in the isoflurane group (P < 0.05). By the end of the examination period, mean blood flow velocity had not yet recovered to the initial values whereby in both groups the mean blood flow velocity was 26% below the initial values. In the isoflurane group, the pulsatility index increased by about 20% (P < 0.05) and remained high until the end of the examination. In the halothane group, however, there were no changes in the pulsatility index. Our results show a remarkable, significant and simultaneous decrease in blood flow velocity in the middle cerebral artery associated with theophylline administration during halothane and isoflurane anaesthesia in man.

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