A Study on the Monitoring of Bupivacaine-induced Cardiac Depression in Dogs: A Comparison between Continuous Mixed Venous Oxygen Saturation and Mean Arterial Blood Pressure

2002 ◽  
Vol 42 (6) ◽  
pp. 795
Author(s):  
Jin Tae Kim ◽  
Jie Ae Kim ◽  
Hyun Sung Cho ◽  
Ka Young Rhee ◽  
Kook Hyun Lee
Keyword(s):  
Blood Pressure ◽  
Oxygen Saturation ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Mixed Venous Oxygen Saturation ◽  
Cardiac Depression ◽  
Arterial Blood ◽  
Venous Oxygen Saturation ◽  
Mixed Venous

Intracranial Pressure and Cerebral Hemodynamic in Patients with Cerebral Tumors

2003 ◽  
Vol 98 (2) ◽  
pp. 329-336 ◽  
Author(s):  
Kurt D. Petersen ◽  
Uffe Landsfeldt ◽  
Georg Emil Cold ◽  
Carsten B. Petersen ◽  
Søren Mau ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Blood Pressure ◽  
Oxygen Saturation ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Jugular Vein ◽  
Arterial Blood ◽  
Group 3 ◽  
Carbon Dioxide Reactivity ◽  
Group 1

Background A critical point during craniotomy is opening of dura, where a high intracranial pressure (ICP) results in swelling of cerebral tissue. Controlled studies concerning ICP, degree of dural tension, and degree of cerebral swelling are therefore warranted. Methods In an open-label study, 117 patients with supratentorial cerebral tumors were randomized to propofol-fentanyl (group 1), isoflurane-fentanyl (group 2), or sevoflurane-fentanyl anesthesia (group 3). Normo- to moderate hypocapnia was applied, with a target level of arterial carbon dioxid tension of 30-40 mmHg. Mean arterial blood pressure was stabilized with intravenous ephedrine (2.5-5 mg) if necessary. Subdural ICP, mean arterial blood pressure, cerebral perfusion pressure (CPP), arteriovenous oxygen difference (AVDo2), internal jugular vein oxygen saturation were monitored before and after a 10-min period of hyperventilation, and the carbon dioxide reactivity was calculated. Furthermore, the tension of dura before and during hyperventilation and the degree of cerebral swelling during hyperventilation and after opening of the dura were estimated by the neurosurgeon. Results No differences were found between groups with regard to demographics, neuroradiologic examination, positioning of the head, and time to ICP measurement. Before and during hyperventilation, ICP was significantly lower and mean arterial blood pressure and CPP significantly higher in group 1 compared with groups 2 and 3 (P < 0.05). The tension of dura before and during hyperventilation was significantly lower in group 1 compared with group2 (P < 0.05), but not significantly different from group 3. In group 1, cerebral swelling after opening of dura was significantly lower compared with groups 2 and 3 (P < 0.05). Furthermore, AVDo was significantly higher and jugular vein oxygen saturation and carbon dioxide reactivity were significantly lower in group 1 compared with groups 2 and 3 (P < 0.05). No significant differences with regard to ICP, CPP, AVDo, carbon dioxide reactivity, and jugular vein oxygen saturation were found between patients anesthetized with isoflurane and sevoflurane. Conclusions The study indicates that before as well as during hyperventilation, subdural ICP and AVDo2 are lower and CPP higher in propofol-anesthetized patients compared with patients anesthetized with isoflurane or sevoflurane. These findings were associated with less tendency for cerebral swelling after opening of dura in the propofol group. The carbon dioxide reactivity in patients anesthetized with isoflurane and sevoflurane was significantly higher than in the propofol group. The differences in subdural ICP between the groups are presumed to be caused by differences in the degree of vasoconstriction elicited by the anesthetic agents, but autoregulatory mechanisms caused by differences in CPP cannot be excluded.

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