Remifentanil decreases oral tissue blood flow while maintaining internal carotid artery blood flow during sevoflurane anesthesia in rabbits

Abstract

The aim of this study was to investigate the effect of remifentanil infusion on oral tissue blood flow including submandibular gland tissue blood flow (SBF) and internal carotid artery blood flow (ICBF) in rabbits during sevoflurane anesthesia. Twelve male Japan White rabbits were anesthetized with sevoflurane and remifentanil. Remifentanil was infused at 0.2 and 0.4 µg/kg/min. Measurements included circulatory variables, common and external carotid artery blood flow (CCBF, ECBF), ICBF, tongue mucosal blood flow (TMBF), masseter muscle tissue blood flow (MBF), mandibular bone marrow tissue blood flow (BBF), tongue muscle tissue blood flow (TBF) and SBF. Vascular resistances for each tissue, including the tongue mucosa, masseter muscle, mandibular bone marrow, tongue muscle and submandibular gland, were calculated by dividing the mean arterial pressure by the respective tissue blood flow. Remifentanil infusion decreased oral tissue blood flow and circulatory variables. CCBF, ECBF and ICBF did not change. The calculated vascular resistance in each oral tissue, except for the tongue mucosa, increased in an infusion-rate-dependent manner. These results showed that remifentanil infusion reduced TMBF, MBF, BBF, TBF and SBF in an infusion-rate-dependent manner without affecting ICBF under sevoflurane anesthesia.

Remifentanil infusion during desflurane anesthesia reduces tissue blood flow while maintaining blood pressure and tissue oxygen tension in the masseter muscle and mandibular bone marrow

“…Remifentanil has been interacted with the α2-adrenoreceptor and might constrict peripheral vasoconstriction in the masseter muscle and mandibular bone marrow [8,11,14]. Hirata et al reported that calculated peripheral vascular resistance in the masseter muscle and mandibular bone marrow increased during remifentanil infusion [10].…”

“…Remifentanil has been interacted with the α2-adrenoreceptor and might constrict peripheral vasoconstriction in the masseter muscle and mandibular bone marrow [ 8 , 11 , 14 ]. Hirata et al reported that calculated peripheral vascular resistance in the masseter muscle and mandibular bone marrow increased during remifentanil infusion [ 10 ]. Therefore, it is considered that the peripheral vascular resistance of the masseter muscle and the mandibular bone marrow might increase and the tissue blood flow decreased during remifentanil infusion.…”

“…Because oral and maxillofacial surgery is performed in the region which has an abundant blood supply, controlling tissue blood flow makes a major contribution to improving the visibility of the surgical field and reducing blood loss. We have previously conducted a number of studies focusing on the effect of volatile anesthetics and opioids on oral tissue blood flow [ 10 , 14 , 15 , 17 ].…”

“…Remifentanil infusion during sevoflurane anesthesia reduces tissue blood flow in the masseter muscle and mandibular bone marrow in a dose-dependent manner [ 15 ]. Hirata et al reported that the reduction in tissue blood flow in the masseter muscle and mandibular bone marrow during remifentanil infusion under sevoflurane anesthesia without changes in internal carotid artery blood flow is greater than the reduction in tissue blood flow in oral mucosa, and suggested that blood flow might be redistributed from the masseter muscle and mandibular bone marrow to skin and oral mucosa [ 10 ]. The reduction in tissue blood flow in the masseter muscle and the mandibular bone marrow can be expected to reduce blood loss during oral surgery, while a reduction in blood flow may cause hypoxia.…”

“…Although previous studies have addressed the effect of remifentanil infusion during sevoflurane anesthesia on oral tissue blood flow and oral tissue oxygen tension [ 10 , 14 , 15 ], no other study has described the relationship of remifentanil infusion to oral tissue blood flow and oral tissue oxygen tension during desflurane anesthesia. We therefore hypothesized that continuous infusion of remifentanil during desflurane anesthesia would reduce tissue blood flow in the masseter muscle and mandibular bone marrow, while maintain the tissue oxygen tension under well-maintained hemodynamics.…”