scholarly journals Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

2019 ◽  
Author(s):  
Marianna Juhász ◽  
Levente Molnár ◽  
Béla Fülesdi ◽  
Tamás Végh ◽  
Dénes Páll ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Cerebral Circulation ◽  
Cerebral Autoregulation ◽  
Applanation Tonometry ◽  
Co2 Reactivity ◽  
Anesthetic Induction ◽  
Hemodynamic Changes ◽  
Entire Study ◽  
Circulatory Effects ◽  
Cerebral Vasoreactivity

Abstract Background: Sevoflurane is one of the most frequently used inhaled anesthetics for general anesthesia. Previously it has been reported that at clinically used doses of sevoflurane, cerebral vasoreactivity is maintained. However, there are no data how sevoflurane influences systemic and cerebral circulation in parallel. The aim of our study was to assess systemic and cerebral hemodynamic changes as well as cerebral CO2-reactivity during sevoflurane anesthesia. Methods: 29 patients undergoing general anesthesia were enrolled. Anesthesia was maintained with 1 MAC sevoflurane in 40% oxygen. Ventilatory settings (respiratory rate and tidal volume) were adjusted to reach and maintain 40, 35 and 30 mmHg EtCO2 for 5 minutes respectively. At the end of each period, transcranial Doppler and hemodynamic parameters using applanation tonometry were recorded. Results: Systemic mean arterial pressure significantly decreased during anesthetic induction and remained unchanged during the entire study period. Central aortic and peripherial pulse pressure and augmentation idex as markers of arterial stiffness significantly increased during the anesthetic induction and remained stable at the time points when target CO2 levels were reached. Both cerebral autoregulation and cerebral CO2-reactivity was maintained at 1 MAC sevoflurane. Discussion: Cerebral autoregulation and CO2-reactivity is preserved at 1 MAC sevoflurane. Cerebrovascular effects of anesthetic compounds have to be assessed together with systemic circulatory effects. The study was registered at http://www.clinicaltrials.gov, identifier: NCT02054143, retrospectively registered.

scholarly journals Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

2019 ◽  
Author(s):  
Marianna Juhász ◽  
Levente Molnár ◽  
Béla Fülesdi ◽  
Tamás Végh ◽  
Dénes Páll ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Cerebral Circulation ◽  
Cerebral Autoregulation ◽  
Augmentation Index ◽  
Applanation Tonometry ◽  
Co2 Reactivity ◽  
Anesthetic Induction ◽  
Entire Study ◽  
Circulatory Effects ◽  
Cerebral Vasoreactivity

Abstract Background: Sevoflurane is one of the most frequently used inhaled anesthetics for general anesthesia. Previously it has been reported that at clinically used doses of sevoflurane, cerebral vasoreactivity is maintained. However, there are no data how sevoflurane influences systemic and cerebral circulation in parallel. The aim of our study was to assess systemic and cerebral hemodynamic changes as well as cerebral CO2-reactivity during sevoflurane anesthesia. Methods: 29 patients undergoing general anesthesia were enrolled. Anesthesia was maintained with 1 MAC sevoflurane in 40% oxygen. Ventilatory settings (respiratory rate and tidal volume) were adjusted to reach and maintain 40, 35 and 30 mmHg EtCO2 for 5 minutes respectively. At the end of each period, transcranial Doppler and hemodynamic parameters using applanation tonometry were recorded. Results: Systemic mean arterial pressure significantly decreased during anesthetic induction and remained unchanged during the entire study period. Central aortic and peripherial pulse pressure and augmentation index as markers of arterial stiffness significantly increased during the anesthetic induction and remained stable at the time points when target CO2 levels were reached. Both cerebral autoregulation and cerebral CO2-reactivity was maintained at 1 MAC sevoflurane. Discussion: Cerebral autoregulation and CO2-reactivity is preserved at 1 MAC sevoflurane. Cerebrovascular effects of anesthetic compounds have to be assessed together with systemic circulatory effects. Doppler Trial Registration: The study was registered at http://www.clinicaltrials.gov, identifier: NCT02054143, retrospectively registered. Date of registration: February 4, 2014.

scholarly journals Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

2019 ◽  
Author(s):  
Marianna Juhász ◽  
Levente Molnár ◽  
Béla Fülesdi ◽  
Tamás Végh ◽  
Dénes Páll ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Transcranial Doppler ◽  
Cerebral Circulation ◽  
Cerebral Autoregulation ◽  
Applanation Tonometry ◽  
Co2 Reactivity ◽  
Anesthetic Induction ◽  
Key Words Sevoflurane ◽  
Entire Study ◽  
Circulatory Effects

Abstract Background: Sevoflurane is one of the most frequently used inhaled anesthetics for general anesthesia. Previously it has been reported that at clinically used doses of sevoflurane, cerebral vasoreactivity is maintained. However, there are no data how sevoflurane influences systemic and cerebral circulation in parallel. The aim of our study was to assess systemic and cerebral hemodynamic changes as well as cerebral CO2-reactivity during sevoflurane anesthesia. Methods: 29 patients undergoing general anesthesia were enrolled. Anesthesia was maintained with 1 MAC sevoflurane in 40% oxygen. Ventilatory settings (respiratory rate and tidal volume) were adjusted to reach and maintain 40, 35 and 30 mmHg EtCO2 for 5 minutes respectively. At the end of each period, transcranial Doppler and hemodynamic parameters using applanation tonometry were recorded. Results: Systemic mean arterial pressure significantly decreased during anesthetic induction and remained unchanged during the entire study period. Central aortic and peripherial pulse pressure and augmentation idex as markers of arterial stiffness significantly increased during the anesthetic induction and remained stable at the time points when target CO2 levels were reached. Both cerebral autoregulation and cerebral CO2-reactivity was maintained at 1 MAC sevoflurane. Discussion: Cerebral autoregulation and CO2-reactivity is preserved at 1 MAC sevoflurane. Cerebrovascular effects of anesthetic compounds have to be assessed together with systemic circulatory effects. Key words: sevoflurane; cerebral blood flow, cerebral autoregulation; CO2-reactivity, applanation tonometry; transcranial Doppler The study was registered at http://www.clinicaltrials.gov, identifier: NCT02054143, retrospectively registered.

scholarly journals Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Marianna Juhász ◽  
Levente Molnár ◽  
Béla Fülesdi ◽  
Tamás Végh ◽  
Dénes Páll ◽  
...  
Keyword(s):  
Cerebral Circulation ◽  
Cerebral Autoregulation ◽  
Co2 Reactivity

Cerebral Autoregulation and CO2 Reactivity in Anterior and Posterior Cerebral Circulation During Sevoflurane Anesthesia

2006 ◽  
Vol 102 (2) ◽  
pp. 560-564 ◽  
Author(s):  
Irene Rozet ◽  
Monica S. Vavilala ◽  
Andrew M. Lindley ◽  
Elizabeth Visco ◽  
Miriam Treggiari ◽  
...  
Keyword(s):  
Cerebral Circulation ◽  
Cerebral Autoregulation ◽  
Sevoflurane Anesthesia ◽  
Co2 Reactivity ◽  
Posterior Cerebral Circulation

Hemodynamic changes in regular antipsychotic users after adrenaline-containing lidocaine injection under general anesthesia: a prospective study

2020 ◽  
Author(s):  
Yoshiki Shionoya ◽  
Eishi Nakamura ◽  
Gentaro Tsujimoto ◽  
Takayuki Koyata ◽  
Asako Yasuda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Dental Treatment ◽  
General Anesthetics ◽  
Dental Procedure ◽  
Hemodynamic Changes ◽  
Lidocaine Injection ◽  
A Prospective Study ◽  
Β Adrenergic Receptors ◽  
Circulation Dynamics

Abstract Background: Local anesthetic containing adrenaline is commonly used in many operations to maintain hemostasis and prolong the duration of anesthesia. Antipsychotic drugs have an α-adrenergic receptor blocking action, and it is thought that β-adrenergic receptors predominate when adrenaline is administered in combination, thus inducing hypotension. Many general anesthetics have vasodilatory effects, and it is possible that blood pressure may decrease further if adrenaline-containing lidocaine is administered to antipsychotic users during anesthesia. This study aimed to assess the circulation dynamics in regular antipsychotics users administered adrenaline-containing lidocaine under general anesthesia in a dental procedure. Methods: Participants included 30 patients regularly using antipsychotics (butyrophenone, phenothiazine, and/or atypical antipsychotics) who were scheduled for dental treatment to be performed under general anesthesia. At five minutes after tracheal intubation, the systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and percutaneous oxygen saturation (SpO2) were measured as a baseline. SBP, DBP, HR, and SpO2 were measured 2, 4, 6, 8, and 10 minutes after the injection of 1.8 mL of 2% lidocaine (32 mg) with 1:80,000 adrenaline (22.5 μg) into the oral cavity. Differences in the SBP, DBP, HR, and SpO2 between baseline and at each time point were analyzed using Dunnett’s test.Results: No significant changes were observed in the SBP, DBP, HR, and SpO2 compared to baseline until ten minutes after the administration of adrenaline-containing lidocaine. No adverse events were observed up to one hour after the administration of adrenaline-containing lidocaine.Conclusions: This study demonstrated that adrenaline used at the usual dose for dental treatment under general anesthesia is unlikely to affect the circulation dynamics of regular antipsychotic users.

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