JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (4) Citing Articles via Google Scholar Google Scholar Articles by Rozet, I. Articles by Lam, A. M. Search for Related Content PubMed PubMed Citation Articles by Rozet, I. Articles by Lam, A. M.

---

NEUROSURGICAL ANESTHESIA

Cerebral Autoregulation and CO₂ Reactivity in Anterior and Posterior Cerebral Circulation During Sevoflurane Anesthesia

Irene Rozet, MD^*, Monica S. Vavilala, MD^*, Andrew M. Lindley, MD, FRCA^*, Elizabeth Visco, CRNA^*, Miriam Treggiari, MD, MPh^*, and Arthur M. Lam, MD, FRCPC^*

Departments of *Anesthesiology, Pediatrics, and Neurological Surgery, University of Washington, Seattle, Washington

Address correspondence and reprint requests to Irene Rozet, MD, Assistant Professor, Harborview Medical Center, Box 359724, 325 Ninth Avenue, Seattle, Washington 98104-2499. Address e-mail to i_rozet{at}hotmail.com.

The purpose of the study was to compare cerebral autoregulation (CA) and CO₂ reactivity (CO₂R) between the anterior and posterior circulation under sevoflurane anesthesia. We studied 9 adult ASA physical status I patients (22–47 yr) scheduled for elective orthopedic surgery. Blood flow velocity in the middle cerebral artery (Vmca) and in the basilar artery (Vba) were measured using transcranial Doppler ultrasonography. For CA testing, arterial blood pressure was increased using phenylephrine infusion. CA was quantified with the autoregulatory index (ARI). CO₂R was investigated at Paco₂ of 30 ± 2.8 mm Hg, 39.4 ± 2.6 mm Hg, and 48.7 ± 2.8 mm Hg. Linear regression analysis was used for CO₂R. We found ARI was preserved in both arteries: ARImca (middle cerebral artery) = 0.72 ± 0.2; ARIba (basilar artery) = 0.66 ± 0.2; P = 0.5. With regard to CO₂R, Vmca increased with slope of 1.7 cm/s/mm Hg Paco₂, Vba increased with slope of 1.5 cm/s/mm Hg Paco₂; P = 0.83. Absolute Vmca was higher compared with Vba; P < 0.05. We conclude that in healthy individuals under 0.5 MAC of sevoflurane and small-dose remifentanil: 1) mean flow velocities of BA are less than those of MCA; 2) autoregulation and CO₂R are preserved in the basilar artery and are similar to those of MCA.

This article has been cited by other articles:

				J. Schoof, W. Lubahn, M. Baeumer, R. Kross, C.-W. Wallesch, A. Kozian, C. Huth, and M. Goertler Impaired cerebral autoregulation distal to carotid stenosis/occlusion is associated with increased risk of stroke at cardiac surgery with cardiopulmonary bypass J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 690 - 696. [Abstract] [Full Text] [PDF]

				J. Dinsmore Anaesthesia for elective neurosurgery Br. J. Anaesth., July 1, 2007; 99(1): 68 - 74. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999