Abstract | BACKGROUND: While the decrease in blood carbon dioxide (CO2 ) secondary to hyperventilation is generally accepted to play a major role in the decrease of cerebral tissue oxygen saturation (SctO2 ), it remains unclear if the associated systemic hemodynamic changes are also accountable. METHODS: Twenty-six patients (American Society of Anesthesiologists I-II) undergoing nonneurosurgical procedures were anesthetized with either propofol- remifentanil (n = 13) or sevoflurane (n = 13). During a stable intraoperative period, ventilation was adjusted stepwise from hypoventilation to hyperventilation to achieve a progressive change in end-tidal CO2 (ETCO2 ) from 55 to 25 mmHg. Minute ventilation, SctO2 , ETCO2 , mean arterial pressure (MAP), and cardiac output (CO) were recorded. RESULTS:
Hyperventilation led to a SctO2 decrease from 78 ± 4% to 69 ± 5% (Δ = -9 ± 4%, P < 0.001) in the propofol- remifentanil group and from 81 ± 5% to 71 ± 7% (Δ = -10 ± 3%, P < 0.001) in the sevoflurane group. The decreases in SctO2 were not statistically different between these two groups (P = 0.5). SctO2 correlated significantly with ETCO2 in both groups (P < 0.001). SctO2 also correlated significantly with MAP (P < 0.001) and CO (P < 0.001) during propofol- remifentanil, but not sevoflurane (P = 0.4 and 0.5), anesthesia. CONCLUSION:
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Authors | B S Alexander, A W Gelb, W W Mantulin, A E Cerussi, B J Tromberg, Z Yu, C Lee, L Meng |
Journal | Acta anaesthesiologica Scandinavica
(Acta Anaesthesiol Scand)
Vol. 57
Issue 5
Pg. 604-12
(May 2013)
ISSN: 1399-6576 [Electronic] England |
PMID | 23278596
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
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Copyright | © 2013 The Acta Anaesthesiologica Scandinavica Foundation. |
Chemical References |
- Anesthetics, Inhalation
- Anesthetics, Intravenous
- Methyl Ethers
- Piperidines
- Carbon Dioxide
- Sevoflurane
- Remifentanil
- Oxygen
- Propofol
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Topics |
- Adult
- Anesthetics, Inhalation
(blood, pharmacology)
- Anesthetics, Intravenous
(blood, pharmacology)
- Blood Pressure
(drug effects)
- Carbon Dioxide
(blood)
- Cardiac Output
(drug effects)
- Cerebrovascular Circulation
- Female
- Humans
- Hyperventilation
(blood, physiopathology)
- Male
- Methyl Ethers
(blood, pharmacology)
- Oxygen
(blood)
- Piperidines
(blood, pharmacology)
- Propofol
(blood, pharmacology)
- Remifentanil
- Sevoflurane
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