Effects of 0.5 and 1.0 MAC isoflurane, sevoflurane and desflurane on intracranial and cerebral perfusion pressures in children

Sponheim, Sjur; Skraastad, Øyvind; Helseth, Eirik; Due-Tønnesen, B; Aamodt, Geir; Breivik, Harald

doi:10.1034/j.1399-6576.2003.00199.x

Cited by 89 publications

(42 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This more pronounced property of desflurane to increase the cerebral blood volume is in concordance with the findings in a recent study in children (25) where all three agents increased ICP as compared with baseline despite moderate hyperventilation but with a tendency towards higher ICP with desflurane. Fig.…”

Section: Comparison Of Cbf At Hypocapniasupporting

confidence: 80%

Desflurane results in higher cerebral blood flow than sevoflurane or isoflurane at hypocapnia in pigs

Holmström¹,

Rosén

Åkeson³

2004

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

Desflurane results in higher cerebral blood flow than sevoflurane or isoflurane at hypocapnia in pigs. Link to publication Citation for published version (APA): Holmström, A., Rosén, I., & Åkeson, J. (2004). Desflurane results in higher cerebral blood flow than sevoflurane or isoflurane at hypocapnia in pigs. Acta Anaesthesiologica Scandinavica, 48(4), 400-404. DOI: 10.1111400-404. DOI: 10. /j.0001-5172.2004 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Background: In clinical neuroanaesthesia, the increase in cerebral blood flow (CBF) and intracranial pressure caused by the cerebral vasodilative effects of an inhalational anaesthetic agent is counteracted by the cerebral vasoconstriction induced by hypocapnia. Desflurane and sevoflurane may have advantages over the more traditionally used isoflurane in neuroanaesthesia but their dose-dependent vasodilative effects at hypocapnia have not been compared in the same model using truly equipotent minimal alveolar concentrations (MACs). Method: Desflurane, sevoflurane and isoflurane were administered in a randomized order to six pigs at 0.5 and 1.0 MAC. The intra-arterial xenon clearance technique was used to calculate CBF. Blood pressure was invasively monitored. Cerebral and systemic physiological variables were recorded first at normocapnia (PaCO 2 5.6 kPa) and then at hypocapnia (PaCO 2 3.5 kPa). Electroencephalographic (EEG) activity was continuously recorded. Results: None of the three agents abolished cerebrovascular reactivity to hyperventilation, and at 0.5 MAC all had similar

show abstract

Section: Comparison Of Cbf At Hypocapniasupporting

confidence: 80%

Desflurane results in higher cerebral blood flow than sevoflurane or isoflurane at hypocapnia in pigs

Holmström¹,

Rosén

Åkeson³

2004

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…However, lumbar punctures were performed under general anaesthesia, which can increase CSF pressure. 24,25 They found no correlation between the opening pressures and the extent of ventriculomegaly. 24 We did not measure opening pressures because the children had neither clinical symptoms nor magnetic resonance imaging signs of increased intracranial pressure.…”

Section: Discussionmentioning

confidence: 99%

Intrathecal baclofen in children with spastic cerebral palsy: a double‐blind, randomized, placebo‐controlled, dose‐finding study

Hoving¹,

Raak²,

Spincemaille³

et al. 2007

Develop Med Child Neuro

View full text Add to dashboard Cite

Intrathecal baclofen (ITB) therapy can be very effective in the treatment of intractable spasticity, but its effectiveness and safety have not yet been thoroughly studied in children with cerebral palsy (CP). The aims of this double‐blind, randomized, placebo‐controlled, dose‐finding study were to select children eligible for continuous ITB infusion, to assess the effective ITB bolus dose, and to evaluate the effects, side effects, and complications. Outcome measures included the original Ashworth scale and the Visual Analogue Scale for individually formulated problems. We studied nine females and eight males, aged between 7 and 16 years (mean age 13y 2mo [SD 2y 9mo]). Twelve children had spastic CP and five had spastic‐dyskinetic CP. One child was classified on the Gross Motor Function Classification System at Level III, two at Level I V, and 14 at Level V. The test treatment worked successfully for all 17 children with an effective ITB bolus dose of 12.5μg in one, 20μg in another, 25μg in 10, and 50μg in five children. ITB significantly reduced muscle tone, diminished pain, and facilitated ease of care. The placebo did not have these effects. Nine side effects of ITB were registered, including slight lethargy in seven children. Fourteen children had symptoms of lowered cerebrospinal fluid pressure. We conclude that ITB bolus administration is effective and safe for carefully selected children with intractable spastic CP.

show abstract

“…In SG, from T20 on, the CPP means were lower than the value registered at T0. This was attributed to a decreased MAP (from T20 on), which influences CPP three to four times more than ICP (Sponheim et al, 2003). In PG, an increase of CPP, at T0, was attributed to MAP increase recorded at the same time.…”

Section: Discussionmentioning

confidence: 97%

Intracranial variables in propofol or sevoflurane-anesthestized dogs subjected to subarachnoid administration of iohexol

Nunes

Leite²,

Paula³

et al. 2011

Arq. Bras. Med. Vet. Zootec.

View full text Add to dashboard Cite

Intracranial variables in propofol or ABSTRACTThe effects of subarachnoid administration of iohexol on intracranial hemodynamic in dogs anesthetized with propofol or sevoflurane were evaluated. Thirty adult animals (10.92.9kg) were distributed into two groups: PG, where propofol was used for induction (100.5mg/kg), followed by a continuous rate infusion at 0.550.15mg/kg/hour, and SG, where sevoflurane was administered for induction (2.5 MAC) and for anesthetic maintenance (1.5 MAC). A fiberoptic catheter was implanted on the right superficial cerebral cortex to monitor intracranial pressure (ICP). After 30 minutes, cerebrospinal fluid (CSF) was collected at the cisterna magna and iohexol was injected. The measurements were performed before CSF collection (TA), after the iohexol injection (T0), and at 10-minute intervals (T10 to T60). Intracranial pressure decreased at T0 in SG. Cerebral perfusion pressure at T0 was higher than at TA, T50 and T60 in PG, but in SG, the mean value at T0 was higher than the ones from T20 to T60. Mean arterial pressure at T0 was higher than at TA in PG, while in SG, the values from T20 to T60 were lower than at T0. The heart rate at T60 was lower than at T0 in PG. Cardiac output at TA was lower than at T60 in SG. The cerebrospinal fluid collection and administration of iohexol promoted decrease in intracranial pressure in sevolflurane-anesthetized dogs and increase in cerebral perfusion pressure in propofol-anesthetized dogs.Keywords: anesthesia, dogs, cerebral autoregulation, myelography Palavras-chave: cão, anestesia, autoregulação cerebral, mielografia RESUMO Avaliaram-se os efeitos da administração subaracnóidea de iohexol sobre a hemodinâmica intracraniana em cães anestesiados com propofol ou sevofluorano. Trinta e dois animais (10,9±2,9kg) foram distribuídos em dois grupos: no GP, o propofol foi usado para indução, 100.5mg/kg, seguido por infusão contínua, 0,55±0,15mg/kg/min; no GS, o sevofluorano foi administrado para indução, 2,5 CAM, e manutenção, 1,5 CAM, da anestesia. O cateter de fibra óptica foi implantado na superfície direita do córtex cerebral para monitorar a pressão intracraniana (PIC). Após 30 minutos, o fluido cerebroespinhal (FCS) foi coletado da cisterna magna e o iohexol injetado. As mensurações ocorreram antes da coleta do FCS (TA), depois da injeção de iohexol (T0) e em intervalos de 10 minutos (T10 a T60

show abstract

Effects of 0.5 and 1.0 MAC isoflurane, sevoflurane and desflurane on intracranial and cerebral perfusion pressures in children

Cited by 89 publications

References 14 publications

Desflurane results in higher cerebral blood flow than sevoflurane or isoflurane at hypocapnia in pigs

Desflurane results in higher cerebral blood flow than sevoflurane or isoflurane at hypocapnia in pigs

Intrathecal baclofen in children with spastic cerebral palsy: a double‐blind, randomized, placebo‐controlled, dose‐finding study

Intracranial variables in propofol or sevoflurane-anesthestized dogs subjected to subarachnoid administration of iohexol

Contact Info

Product

Resources

About