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Anesth Analg 2002;94:661-666
© 2002 International Anesthesia Research Society

NEUROSURGICAL ANESTHESIA

Cerebral Blood Volume and Blood Flow Responses to Hyperventilation in Brain Tumors During Isoflurane or Propofol Anesthesia

Aleksa Cenic, MSc*, Rosemary A. Craen, MB BS{dagger}, Ting-Yim Lee, PhD*, and Adrian W. Gelb, MB ChB{dagger}

*Department of Radiology and Lawson Research Institute, St. Joseph’s Health Centre, Imaging Research Laboratories, Robart’s Research Institute and Department of Medical Biophysics, University of Western Ontario, London; and {dagger}Department of Anesthesia, London Health Sciences Centre, and University of Western Ontario, London, Canada

Address correspondence and reprint requests to Dr. Rosemary A. Craen, Department of Anesthesia, University Campus, London Health Sciences Centre, London, Canada, N6A 5A5. Address e-mail to rcraen{at}uwo.ca

Using computerized tomography, we measured absolute cerebral blood flow (CBF) and cerebral blood volume (CBV) in tumor, peri-tumor, and contralateral normal regions, at normocapnia and hypocapnia, in 16 rabbits with brain tumors (VX2 carcinoma), under isoflurane or propofol anesthesia. In both anesthetic groups, CBV and CBF were highest in the tumor region and lowest in the contralateral normal tissue. For isoflurane, a significant decrease in both CBV and CBF was observed in all tissue regions with hyperventilation (P < 0.05), but without accompanying changes in intracranial pressure. However, the percent reduction in regional CBF with hypocapnia was two times larger than that observed in the CBV response (P < 0.01). In contrast, there were no significant changes in CBV and CBF in the Propofol group with hyperventilation for all regions (P > 0.10). In addition, there were no differences between CBV values for isoflurane at hypocapnia when compared with CBV values for propofol at normo- or hypocapnia (P > 0.34 and P > 0.35, respectively, in the tumor regions). Our results indicate that propofol increases cerebral vascular tone in both neoplastic and normal tissue vessels compared with isoflurane. CBV and CBF during normocapnia were significantly greater in all regions (tumor, peri-tumor, and contralateral normal tissue) with isoflurane than with propofol. CBV and CBF remained responsive to hyperventilation only with isoflurane.

IMPLICATIONS: In rabbits with brain tumors, brain blood flow and volume were significantly larger in all regions (tumor, peri-tumor, and contralateral normal tissue) with isoflurane than with propofol during normocapnia, and remained responsive to a reduction in PaCO2. Consequently, during hypocapnia, brain blood flow and volume values with isoflurane were similar to values with propofol.




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A. W. Gelb, R. A. Craen, G. S. U. Rao, K. R. M. Reddy, J. Megyesi, B. Mohanty, H. H. Dash, K. C. Choi, and M. T. V. Chan
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[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins 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 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.