Positron Emission Tomography Study of Regional Cerebral Metabolism during General Anesthesia with Xenon in Humans

Rex, Steffen; Schaefer, Wolfgang M.; Meyer, Philipp; Rossaint, Rolf; Boy, Christian; Setani, K.; Büll, U; Baumert, J.‐H.

doi:10.1097/00000542-200611000-00014

Cited by 61 publications

(58 citation statements)

References 53 publications

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“…31 The coupling of cerebral glucose metabolism and cerebral blood flow was preserved during xenon 60% anesthesia. 32 Occurrence of severe neuropathology in xenon groups despite preservation of PRX indicates operation of other mechanisms of cell death uninfluenced by xenon or HT. As hypothermia and xenon have different effects on autoregulation, they are likely to have different methods of action, which might account for the additive neuroprotective effect.…”

Section: Discussionmentioning

confidence: 99%

Effects of Xenon and Hypothermia on Cerebrovascular Pressure Reactivity in Newborn Global Hypoxic—ischemic Pig Model

Chakkarapani

Dingley

Aquilina

et al. 2013

J Cereb Blood Flow Metab

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Autoregulation of cerebral perfusion is impaired in hypoxic-ischemic encephalopathy. We investigated whether cerebrovascular pressure reactivity (PRx), an element of cerebral autoregulation that is calculated as a moving correlation coefficient between averages of intracranial and mean arterial blood pressure (MABP) with values between À 1 and þ 1, is impaired during and after a hypoxic-ischemic insult (HI) in newborn pigs. Associations between end-tidal CO 2 , seizures, neuropathology, and PRx were investigated. The effect of hypothermia (HT) and Xenon (Xe) on PRx was studied. Pigs were randomized to Sham, and after HI to normothermia (NT), HT, Xe or xenon hypothermia (XeHT). We defined PRx 40.2 as peak and negative PRx as preserved. Neuropathology scores after 72 hours of survival was grouped as 'severe' or 'mild.' Secondary PRx peak during recovery, predictive of severe neuropathology and associated with insult severity (P ¼ 0.05), was delayed in HT (11.5 hours) than in NT (6.5 hours) groups. Seizures were associated with impaired PRx in NT pigs (P ¼ 0.0002), but not in the HT/XeHT pigs. PRx was preserved during normocapnia and impaired during hypocapnia. Xenon abolished the secondary PRx peak, increased (mean (95% confidence interval (CI)) MABP (6.5 (3.8, 9.4) mm Hg) and cerebral perfusion pressure (5.9 (2.9, 8.9) mm Hg) and preserved the PRx (regression coefficient, À 0.098 (95% CI ( À 0.18, À 0.01)), independent of the insult severity.

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Section: Discussionmentioning

confidence: 99%

Effects of Xenon and Hypothermia on Cerebrovascular Pressure Reactivity in Newborn Global Hypoxic—ischemic Pig Model

Chakkarapani

Dingley

Aquilina

et al. 2013

J Cereb Blood Flow Metab

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“…Ketamine, unlike other anaesthetics, does not reduce the cortical electrical activity during anaesthesia, but it does reduce the cortical connectivity in the gamma domain [14,17], while xenon reduces the cortical electrical activity, but increases the cortical connectivity in the gamma domain during deep anaesthesia. Regarding the action on cerebral metabolism, xenon, unlike ketamine, produces a global decrease in metabolic activity [18,19]. Therefore, these changes observed during xenon anaesthesia do not appear to be linked to the action on the NMDA receptor.…”

Section: Discussionmentioning

confidence: 97%

ECoG spectrum changes at different xenon-isoflurane anaesthesia depths

Pavel

Acatrinei

Maria

et al. 2017

Rom J Anaesth Int Care

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Background and aims. The purpose of this study is to assess the frontal and parietal ECoG spectrum (gamma range) changes during isoflurane and combined xenon-isoflurane anaesthesia in rats.Methods. Experiments were carried out on four adult male Sprague-Dawley rats (250-300 g). The anaesthesia was induced with isoflurane and maintained with isoflurane and a xenon-isoflurane mixture. The rats were maintained at two different anaesthetic depths: light (isoflurane anaesthesia) and deep (isoflurane and xenon-isoflurane anaesthesia). The frontal and the parietal cortical activity was assessed by computing the median frequency, spectral edge frequency and functional connectivity between these two areas during light and deep anaesthesia.Results. We noticed a decrease in cortical connectivity under deep isoflurane anaesthesia and an increase in connectivity under deep xenon-isoflurane anaesthesia. Moreover, during xenon-isoflurane anaesthesia, a trend of regularity of electro-cortical activity was present compared with isoflurane anaesthesia.Conclusions. Xenon-isoflurane deep anaesthesia demonstrated a series of specific ECoG features regarding frontoparietal functional connectivity (gamma range connectivity increase) and regularity of the electrocortical activity compared with isoflurane anaesthesia.

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“…1). 19,20 In brief, each subject twice underwent two PET scans in a fixed order: The first two PET scans were performed during wakefulness (assessment of baseline MBF), the subsequent two PET scans were acquired during general anesthesia with 1 MAC xenon (assessment of MBF during xenon anesthesia). MBF was measured using 15 O-labeled water (H 2 15 O), which is a commonly used, freely diffusible PET tracer.…”

Section: Study Protocolmentioning

confidence: 99%

“…20 Administration of xenon was stopped and the laryngeal mask airway removed after spontaneous breathing had resumed. After subjects emerged from anesthesia, they were monitored for stable vital signs for at least 1 h and discharged in accordance with the standards of our department for outpatient anesthesia.…”

Section: Anesthesiamentioning

confidence: 99%

Myocardial Blood Flow during General Anesthesia with Xenon in Humans

Schaefer

Meyer

Rossaint³

et al. 2011

Anesthesiology

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Background: Xenon has only minimal hemodynamic side effects and induces pharmacologic preconditioning. Thus, the use of xenon could be an interesting option in patients at risk for perioperative myocardial ischemia. However, little is known about the effects of xenon anesthesia on myocardial blood flow (MBF) and coronary vascular resistance in humans. Methods: Myocardial blood flow was noninvasively quantified by H 2 15 O positron emission tomography in six healthy volunteers (age: 38 Ϯ 8 yr). MBF was measured at baseline and during general anesthesia induced with propofol and maintained with xenon, 59 Ϯ 0%. Absolute quantification

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Positron Emission Tomography Study of Regional Cerebral Metabolism during General Anesthesia with Xenon in Humans

Abstract: Xenon induces metabolic depression in the human brain, suggesting that the inhibition of the glutamatergic system is likely to be of minor significance for the anesthetic action of xenon in vivo.

Cited by 61 publications

References 53 publications

Effects of Xenon and Hypothermia on Cerebrovascular Pressure Reactivity in Newborn Global Hypoxic—ischemic Pig Model

Effects of Xenon and Hypothermia on Cerebrovascular Pressure Reactivity in Newborn Global Hypoxic—ischemic Pig Model

ECoG spectrum changes at different xenon-isoflurane anaesthesia depths

Myocardial Blood Flow during General Anesthesia with Xenon in Humans

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