The Differential Effects of Prostaglandin E1 and Nitroglycerin on Regional Cerebral Oxygenation in Anesthetized Patients

Kadoi, Yuji; Saïto, Shigeru; Morita, Toshihiro; Imai, Takasuke; Kawahara, Huminori; FUJITA, NAO; Goto, Fumio

doi:10.1097/00132586-199810000-00006

Cited by 5 publications

(8 citation statements)

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“…8 In the present study, NC and NTG altered this pattern. Augmented pulsatility in the systemic circulation and an increase in intracranial pressure, 14,16 [23][24] The difference between our results and theirs may be explained because our patients had sympathetic stimulation by ECT and vasodilative action of thiopental sodium, simultaneously.…”

Section: Effect Of Each Anti-hypertensive Drug On Cerebral Hemodynamicscontrasting

confidence: 77%

“…Drug doses were chosen based on the literature 6,12-13 and on previous clinical experience. [14][15] The identities of the study drugs were unknown to all persons present at the ECT session. The data obtained during this study were analyzed later by an individual who was also unaware of treatment regimens.…”

Section: Methodsmentioning

confidence: 99%

“…1 9 PGE1 dilates arteries via prostaglandin receptors on smooth muscle cells. [13][14] Nitroglycerin is a NO donor, which relaxes smooth muscle through a cyclic GMP-dependent cascade. 6,13 Several reports describe adrenergic blocking agents as the best choice for blood pressure control during ECT, 1 8 because activation of the adrenergic system is considered a major cause of this phenomenon.…”

Section: Effect Of Each Anti-hypertensive Drug On Systemic Hemodynamicsmentioning

confidence: 99%

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

Saito

Kikuchi

Iriuchijima

et al. 2000

Can J Anesth/J Can Anesth

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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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Section: Effect Of Each Anti-hypertensive Drug On Cerebral Hemodynamicscontrasting

confidence: 77%

Section: Methodsmentioning

confidence: 99%

Section: Effect Of Each Anti-hypertensive Drug On Systemic Hemodynamicsmentioning

confidence: 99%

See 1 more Smart Citation

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

Saito

Kikuchi

Iriuchijima

et al. 2000

Can J Anesth/J Can Anesth

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“…For example, the use of near-infrared spectrometry measuring cerebral oxygen saturation has demonstrated that NTG supports or may increase brain oxygenation. 15,16 Analogously, another study demonstrated increased vascular diameter, blood flow, and endothelial permeability by using a different vasodilator, captopril (nitric oxide donator), in both in vitro and in vivo models. 17 The results obtained in this study also indicate that the infusion of NTG has a significant effect on the vascular permeability in the brain of some but not all animals.…”

Section: Discussionmentioning

confidence: 96%

Intravenous Infusion of Nitroglycerine Leads to Increased Permeability on Dynamic Contrast-Enhanced MR Imaging in Pig Brains

Carl¹,

Tideman²,

Ravn³

et al. 2015

American Journal of Neuroradiology

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“…Nicardipine, a calcium channel blocker that has potent systemic vasodilatory effects without negative inotropic, chronotropic, and dromotropic effects, and that does not increase intracranial pressure, is sometimes used for induced hypotension [6][7][8][9]. Abe et al [7] examined the effects of nicardipine (initial infusion rate, 0.5 µg·kg −1 ·min −1 ) on CO 2 reactivity in nondiabetic patients under isofl urane anesthesia, and found that CO 2 reactivity did not change during the hypotension induced by nicardipine.…”

Section: Introductionmentioning

confidence: 99%

Effects of nicardipine-induced hypotension on cerebrovascular carbon dioxide reactivity in patients with diabetes mellitus under sevoflurane anesthesia

Kikuchi

Goto

2007

J Anesth

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The Differential Effects of Prostaglandin E1 and Nitroglycerin on Regional Cerebral Oxygenation in Anesthetized Patients

Cited by 5 publications

References 0 publications

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

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

Intravenous Infusion of Nitroglycerine Leads to Increased Permeability on Dynamic Contrast-Enhanced MR Imaging in Pig Brains

Effects of nicardipine-induced hypotension on cerebrovascular carbon dioxide reactivity in patients with diabetes mellitus under sevoflurane anesthesia

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