Effect of sevoflurane on cerebral blood flow and cerebrovascular resistance at surgical level of anaesthesia: A transcranial Doppler study

C. Molnár, G. Settakis, P. Sárkány, S. Kálmán, S. Szabó, B. Fülesdi

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background and objective: It is widely accepted that sevoflurane affects cerebral circulation, but there are uncertainities regarding the magnitude of its effect. The aim of the present work was to assess the effect of sevoflurane on the cerebral circulation at surgical levels of anaesthesia. Methods: Twenty patients undergoing elective lumbar discectomies were investigated. Anaesthesia was induced with propofol and maintained with sevoflurane. The level of surgical anaesthesia was determined by bispectral index, the target level was 45-55. Transcranial Doppler (TCD) measurement was performed before induction and after reaching the surgical level of anaesthesia. Besides routine parameters (middle cerebral artery mean blood flow velocity (MCAV) and pulsatility index (PI)) derived parameters (estimated cerebral perfusion pressure (eCPP), cerebral blood flow index (CBFI) and resistance area product (RAP)) were calculated by taking changes of mean arterial pressure also into account. Results: MCAV decreased from 54.1 ± 13.3 to 43.7 ± 18.5 cm s-1, P <0.01 and PI increased from 0.79 ± 0.2 to 0.92 ± 0.2, P <0.01 after reaching the surgical level of anaesthesia. As a result eCPP decreased by 18.2%, CBFI by 25.5% and RAP increased by 15% respectively. Conclusions: Our data indicate a vasodilatory effect of sevoflurane at surgical level of anaesthesia on large cerebral vessels or a vasoconstriction of the resistance arterioles likely caused by decreased brain metabolism.

Original languageEnglish
Pages (from-to)179-184
Number of pages6
JournalEuropean Journal of Anaesthesiology
Volume24
Issue number2
DOIs
Publication statusPublished - Feb 2007

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Cerebrovascular Circulation
Anesthesia
Diskectomy
Blood Flow Velocity
Middle Cerebral Artery
Arterioles
Propofol
Vasoconstriction
sevoflurane
Arterial Pressure
Brain

Keywords

  • Anaesthesia general
  • Cerebrovascular circulation
  • Sevoflurane
  • Ultrasonography doppler transcranial

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Effect of sevoflurane on cerebral blood flow and cerebrovascular resistance at surgical level of anaesthesia : A transcranial Doppler study. / Molnár, C.; Settakis, G.; Sárkány, P.; Kálmán, S.; Szabó, S.; Fülesdi, B.

In: European Journal of Anaesthesiology, Vol. 24, No. 2, 02.2007, p. 179-184.

Research output: Contribution to journalArticle

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