We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Cerebral blood flow change during volatile induction in large-dose sevoflurane versus intravenous propofol induction: transcranial Doppler study.
- Authors
Hwa Sung Jung; Jin Sun Kim; Tae-Yun Sung; Hyun Kang; Tae-Yop Kim
- Abstract
Background: The impact of volatile induction using large-dose sevoflurane (VI-S) on cerebral blood flow has not been well investigated. The present study compared the changes in cerebral blood flow of middle cerebral artery using transcranial Doppler (TCD) during VI-S and conventional induction using propofol. Methods: Patients undergoing elective lumbar discectomy were randomly allocated to receive either sevoflurane (8%, Group VI-S, n = 11) or target-controlled infusion of propofol (effect site concentration, 3.0 g/ml; Group P, n = 11) for induction of anesthesia. The following data were recorded before and at 1, 2, and 3 min after commencement of anesthetic induction (T0, T1, T2, and T3, respectively): mean velocity of the middle cerebral artery (VMCA) by TCD, mean blood pressure (MBP), heart rate, bispectral index score (BIS) and end-tidal CO2 (ETCO2). Changes in VMCA and MBP from their values at T0 (AVmca and AMBP) at T1, T2, and T3 were also determined. Results: BISs at T1, T2 and T3 were significantly less than that at T0 in both groups (P < 0.05). AVMCA in Group VI-S at T2 and T3 (18.1% and 12.4%, respectively) were significantly greater than those in Group P (-7.6% and -19.8%, P = 0.006 and P < 0.001, respectively), whereas ETCO2 and AMBP showed no significant intergroup difference. Conclusions: VI-S using large-dose sevoflurane increases cerebral blood flow resulting in luxury cerebral flow-metabolism mismatch, while conventional propofol induction maintains cerebral flow-metabolism coupling. This mismatch in VI-S may have to be considered in clinical application of VI-S.
- Subjects
CEREBRAL circulation; INHALATION administration; SEVOFLURANE; PROPOFOL; TRANSCRANIAL Doppler ultrasonography; BLOOD pressure; DISCECTOMY
- Publication
Korean Journal of Anesthesiology, 2014, Vol 67, Issue 5, p323
- ISSN
2005-6419
- Publication type
Article
- DOI
10.4097/kjae.2014.67.5.323