Regional Cerebral Oxygen Saturation During Electroconvulsive Therapy

Saito, Shigeru; Miyoshi, Sohtaro; Yoshikawa, Daisuke; SHIMAD, HITOSHI; Morita, Toshihiro; Kitani, Yasuharu; Leonard, Irene; Cunningham, Anthony J.

doi:10.1097/00132586-199712000-00050

Cited by 7 publications

(10 citation statements)

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“…Our finding of increased SaO 2 in the post-ictal period as compared with pre-ictal baseline has been shown by other investigators using the Invos 16,17 , and by Penfield 18 while monitoring seizure patients during neurosurgery. Furthermore, Adelson et al 9,10 reported increased SaO 2 several hours before the onset of CPS, a finding not substantiated in our study.…”

Section: Discussionsupporting

confidence: 86%

“…In contrast to the change seen during CPS, SaO 2 decreased during the ictal phase of RCPS. Similarly, studies of cerebral oximetry using the Invos with patients undergoing electroshock therapy have shown decreased oxygenation during generalized convulsive seizure 16,17 . One explanation for this difference between he focal and generalized seizures is that blood is more evenly distributed across the two hemispheres during generalized seizures.…”

Section: Discussionmentioning

confidence: 96%

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Near infrared spectroscopy (NIRS) distinguishes seizure types

Sokol¹,

Markand²,

Daly³

et al. 2000

Seizure

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Near infrared spectroscopy (NIRS) is a noninvasive method for bedside measurement of cerebral oxygenation (SaO(2)). The purpose of this study was to establish differences in SaO(2)for complex partial seizures (CPS) and rapidly secondarily generalized CPS (RCPS). We studied eight adults with medically refractory epilepsy undergoing evaluation for temporal lobectomy. We continually measured cerebral SaO(2)via a Somanetic Invos 3100a cerebral oximeter, pre-ictal (5 minutes), ictal, immediate (30 seconds) post-ictal, and late post-ictal (5 minutes after ictus). Seventeen seizures (12 CPS, four RCPS and one subclinical) were recorded in eight patients. The percentage change in cerebral SaO(2)from pre-ictal to ictal periods was derived. Cerebral SaO(2)increased (percentage change, mean: 16.6, SD: 13.9) for CPS and decreased (percentage change, mean: 51.1, SD: 18.1) for RCPS. No change in cerebral oximetry was recorded for the subclinical seizure. Post-ictal (immediate and late) increase in cerebral SaO(2)was seen for 11 of the 17 seizures (nine CPS and two RCPS). Peripheral SaO(2)rose greater than 93% for all CPS and the subclinical seizure, but decreased between 78 and 84% during RCPS. These results suggest NIRS distinguishes cerebral SaO(2)patterns between CPS and RCPS. The decrease in peripheral SaO(2), however, may account for the decrease in cerebral SaO(2)seen in generalized seizures.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 96%

Near infrared spectroscopy (NIRS) distinguishes seizure types

Sokol¹,

Markand²,

Daly³

et al. 2000

Seizure

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“…Hypotension upon declamping of the aorta may contribute to the delayed increase in S c O 2 29 . S c O 2 started to rise after five minutes when MAP had been restored and MCA V mean had increased to a peak level.…”

Section: Discussionmentioning

confidence: 99%

Middle Cerebral Artery Flow Velocity and Cerebral Oxygenation during Abdominal Aortic Surgery

Liu

Burcev

Pott

et al. 1999

Anaesth Intensive Care

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Cerebral perfusion was evaluated in twelve patients undergoing elective infra-renal abdominal aortic aneurysmectomy by transcranial Doppler ultrasonography-determined middle cerebral artery mean flow velocity, near-infrared spectroscopy-assessed cerebral oxygen saturation and systemic haemodynamic variables. The middle cerebral artery mean flow velocity and cerebral oxygen saturation decreased during cross-clamping of the aorta, and both increased upon declamping of the aorta with the oxygen saturation change lagging behind the change in the flow velocity. The changes in cerebral flow velocity and oxygen saturation paralleled the deviations in cardiac output and end-tidal carbon dioxide tension.

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“…9 We have also demonstrated temporary cerebral hyperemia after electrical shock by utilizing near-infrared spectrophotometry. 10 It is important to examine to what extent systemic hemodynamic stabilization influences the cerebral hemodynamic alterations after electrically induced seizure. Anti-hypertensive medication may reduce cerebral perfusion pressure excessively, so that oxygen delivery is not fulfilled.…”

mentioning

confidence: 99%

Reduction of cerebral hyperemia with anti-hypertensive medication after electroconvulsive therapy

Saito

Kikuchi

Iriuchijima

et al. 2000

Can J Anesth/J Can Anesth

Self Cite

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REPORTS OF INVESTIGATION 767CAN J ANESTH 2000 / 47: 8 / pp [767][768][769][770][771][772][773][774] Purpose: Several different anti-hypertensive regimens have been introduced for the prevention of systemic hyperdynamic responses after electrically induced seizures. In the present study, the effects of anti-hypertensive medications on cerebral circulation were studied.Methods: Systemic blood pressure was controlled by several anti-hypertensive medications, nicardipine, prostaglandin E1, alprenolol and nitroglycerin, in 30 patients (150 electroconvulsive therapy trials). Changes in cerebral blood flow velocity were measured by transcranial Doppler sonography of the right middle cerebral artery from the start of anesthesia to 10 min after the electrical shock.Results: Administration of a Ca 2+ antagonist, nicardipine, or prostaglandin E1 did not alter the augmented cerebral blood flow velocity after the seizure. However, a ß-adrenergic blocking agent, alprenolol (P < 0.05) or nitroglycerin (P < 0.01) partially inhibited the increase in cerebral blood flow velocity. Maximal blood flow velocity was 133% larger than the pre-anesthesia value in the control group, 109% in the nicardipine group, 113% in the prostaglandin E1 group, 72% in the alprenolol group, and 45% in the nitroglycerin group, respectively. The increase in cerebral blood flow velocity after electrically induced seizure was independent of systemic blood pressure. Internal jugular venous saturation (SjO 2 ) was increased, and difference in arterial and venous concentrations of lactate was not altered in all groups.Conclusions: Cerebral hemodynamics is altered by ECT, even when systemic hemodynamics are stabilized by antihypertensive medication. Although the effects of antihypertensive medicine on cerebral hemodynamics are variable, systemic blood pressure control by these agents does not induce cerebral ischemia after ECT.Objectif : Différentes thérapies antihypertensives ont été proposées comme moyen de prévention des répon-ses hyperdynamiques généralisées à la suite d'électrochocs. Dans la présente étude, on a analysé les effets de médicaments antihypertenseurs sur la circulation cérébrale.Méthode : La pression sanguine générale a été contrôlée par différents médicaments antihypertenseurs, la nicardipine, la prostaglandine E 1 , l'alprénolol et la nitroglycérine, chez 30 patients lors de 150 essais d'électro-chocs. Les changements de vitesse circulatoire cérébrale ont été mesurés par échographie Doppler transcrâni-enne de l'artère cérébrale moyenne droite, du début de l'anesthésie jusqu'à 10 min après l'électrochoc.Résultats : L'administration d'un antagoniste de Ca 2 +, la nicardipine, ou la prostaglandine E 1 n'ont pas modifié la vitesse circulatoire cérébrale augmentée après les convulsions. Toutefois, un agent ß-bloquant, l'alprénolol (P < 0,05) ou la nitroglycérine (P < 0,01) ont partiellement inhibé l'augmentation de vitesse circulatoire cérébrale. La vitesse circulatoire maximale a été 133 % de la valeur préanesthésique mesurée dans le groupe tém...

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Regional Cerebral Oxygen Saturation During Electroconvulsive Therapy

Cited by 7 publications

References 0 publications

Near infrared spectroscopy (NIRS) distinguishes seizure types

Near infrared spectroscopy (NIRS) distinguishes seizure types

Middle Cerebral Artery Flow Velocity and Cerebral Oxygenation during Abdominal Aortic Surgery

Reduction of cerebral hyperemia with anti-hypertensive medication after electroconvulsive therapy

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