Transkranielle Dopplersonographie: Effekte intravenöser Anästhetika bei neurochirurgischen Patienten

Schregel, W.; Bredenkötter, U; Sihle-Wissel, M.; Cunitz, G

doi:10.1055/s-2007-1003988

Cited by 6 publications

(1 citation statement)

References 8 publications

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“…[ 18 19 ] In a study by Schregel et al ., cerebral vascular effects of halothane, alfentanil, and propofol were compared. [ 20 ] The PI showed a shortterm increase after alfentanil, decrease after halothane, and strong increase after infusion of propofol. The changes in PI values were consistent with vasodilatory effect of halothane and vasoconstrictory effect of propofol and alfentanil.…”

Section: Discussionmentioning

confidence: 99%

Cerebral vascular effects of loading dose of dexmedetomidine: A Transcranial Color Doppler study

Arulvelan

Sethuraman

Easwer

et al. 2016

Indian Journal of Critical Care Medicine

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Background:Dexmedetomidine has been widely used in critical care settings because of its property of maintaining stable hemodynamics and inducing conscious sedation. The use of dexmedetomidine is in increasing trend particularly in patients with neurological disorders. Very few studies have focused on the cerebral hemodynamic effects of dexmedetomidine. This study is aimed to address this issue.Methods:Thirty patients without any intracranial pathology were included in this study. Middle cerebral artery flow velocity obtained from transcranial color Doppler was used to assess the cerebral hemodynamic indices. Mean flow velocity (mFV), pulsatility index (PI), cerebral vascular resistant index (CVRi), estimated cerebral perfusion pressure (eCPP), and zero flow pressure (ZFP) were calculated bilaterally at baseline and after infusion of injection Dexmedetomidine 1 mcg/Kg over 10 min.Results:Twenty-six patients completed the study protocol. After administration of loading dose of dexmedetomidine, mFV and eCPP values were significantly decreased in both hemispheres (P < 0.05); PI, CVRi, and ZFP values showed significant increase (P < 0.05) after dexmedetomidine infusion.Conclusion:Increase in PI, CVRi, and ZFP suggests that there is a possibility of an increase in distal cerebral vascular resistance (CVR) with loading dose of dexmedetomidine. Decrease in mFV and eCPP along with an increase in CVR may lead to a decrease in cerebral perfusion. This effect can be exaggerated in patients with preexisting neurological illness. Further studies are needed to evaluate the effect of dexmedetomidine on various other pathological conditions involving brain like traumatic brain injury and vascular malformations.

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Section: Discussionmentioning

confidence: 99%