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 Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Joshi, S. Articles by Pile-Spellman, J. Search for Related Content PubMed PubMed Citation Articles by Joshi, S. Articles by Pile-Spellman, J. Related Collections Cardiovascular Neuroanesthesia

---

NEUROSURGICAL ANESTHESIA

In Nonhuman Primates Intracarotid Adenosine, but Not Sodium Nitroprusside, Increases Cerebral Blood Flow

Shailendra Joshi, MD^*, Houng Duong, MD, Sundeep Mangla, MD, Mei Wang, MS^*, Adam D. Libow, BA^*, Sulli J. Popilskis, DVM^*, Noeleen D. Ostapkovich, R.EEG/EPT, Theodore S. Wang, PhD, William L. Young, MD^||, and John Pile-Spellman, MD^¶

Departments of *Anesthesiology, Radiology, Neurology, and ¶Neurological Surgery and the Institute of Comparative Medicine, College of Physicians and Surgeons of Columbia University, New York, New York; and ||Departments of Anesthesiology, Neurology, and Neurosurgery, University of California, San Francisco, California

Address correspondence to Shailendra Joshi, MD, Department of Anesthesiology, P&S P Box 46, College of Physicians and Surgeons of Columbia University, 630 W. 168th St., New York, NY 10032. Address e-mail to sj121{at}columbia.edu No reprints will be available.

Intracarotid infusion of short-acting vasodilators, such as adenosine and nitroprusside, in doses that lack significant systemic side effects, may permit controlled manipulation of cerebrovascular resistance. In this experiment we assessed changes in cerebral blood flow (CBF) after intracarotid infusion of nitroprusside and adenosine. The study was conducted on six adult baboons under isoflurane anesthesia and controlled ventilation. Intracarotid drug infusion protocol avoided hypotension during nitroprusside infusion and tested for autoregulatory vasoconstriction. CBF (intraarterial ¹³³Xe technique) was measured four times during infusions of 1) intracarotid saline, 2) IV phenylephrine (0.2 µg · kg^-1 · min^-1) aimed to increase mean arterial pressure by 10–15 mm Hg, 3) IV phenylephrine and intracarotid nitroprusside (0.5 µg · kg^-1 · min^-1), and 4) intracarotid adenosine (1 mg/min). IV phenylephrine increased mean arterial pressure (69 ± 8 to 91 ± 9 mm Hg, P < 0.0001, n = 6), and concurrent infusion of intracarotid nitroprusside reversed this effect. However, compared with baseline, CBF did not change with IV phenylephrine or with concurrent infusion of IV phenylephrine and intracarotid nitroprusside. Intracarotid adenosine profoundly increased CBF (from 29 ± 8 to 75 ± 32 mL · 100 g^-1 · min^-1; P < 0.0001). In nonhuman primates, intracarotid adenosine increases CBF in doses that lack significant systemic side effects, whereas intracarotid nitroprusside has no effect. Intracarotid adenosine may be useful for manipulating cerebrovascular resistance and augmenting CBF during cerebral ischemia.

IMPLICATIONS: Intraarterial ¹³³Xe cerebral blood flow (CBF) measurements suggest that intracarotid adenosine, in a dose that lacks significant systemic side effects, profoundly increases CBF, whereas nitroprusside has no effect.(5–12)

This article has been cited by other articles:

				S. Lavi, D. Gaitini, V. Milloul, and G. Jacob Impaired cerebral CO2 vasoreactivity: association with endothelial dysfunction Am J Physiol Heart Circ Physiol, October 1, 2006; 291(4): H1856 - H1861. [Abstract] [Full Text] [PDF]

				S. Joshi, R. Hartl, M. Wang, L. Feng, D. Hoh, R. R. Sciacca, and S. Mangla The Acute Cerebrovascular Effects of Intracarotid Adenosine in Nonhuman Primates Anesth. Analg., July 1, 2003; 97(1): 231 - 237. [Abstract] [Full Text] [PDF]

				S. Lavi, R. Egbarya, R. Lavi, and G. Jacob Role of Nitric Oxide in the Regulation of Cerebral Blood Flow in Humans: Chemoregulation Versus Mechanoregulation Circulation, April 15, 2003; 107(14): 1901 - 1905. [Abstract] [Full Text] [PDF]