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The influence of nitroglycerin and prostaglandin E 1 on dynamic cerebral autoregulation in adult patients during propofol and fentanyl anaesthesia*
Author(s) -
Endoh H.,
Honda T.,
Ohashi S.,
Hida S.,
Shibue C.,
Komura N.
Publication year - 2001
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2001.02225.x
Subject(s) - medicine , cerebral autoregulation , anesthesia , propofol , fentanyl , cerebral blood flow , mean arterial pressure , transcranial doppler , middle cerebral artery , autoregulation , blood pressure , bispectral index , cardiology , heart rate , ischemia
We investigated dynamic cerebral autoregulation in 24 normocapnic adult patients during propofol and fentanyl anaesthesia. Hypotension was induced, to a mean arterial pressure (MAP) of 60–65 mmHg, using nitroglycerin or prostaglandin E 1. Time‐averaged mean cerebral blood flow velocity in the right middle cerebral artery was measured continuously using transcranial Doppler sonography. Dynamic autoregulatory response was activated by a sudden decrease in MAP following release of bilateral thigh cuffs (thigh cuff test) and evaluated as a dynamic rate of autoregulation (dRoR in %.s −1 ). The cuff test was repeated to obtain two values of dRoR during baseline and during induced hypotension; the data were then averaged. The mean value of dRoR during baseline and during induced hypotension was 14.2 (2.9) and 14.2 (1.6) %.s −1 , respectively, in the nitroglycerin group, and 14.6 (2.6) and 14.4 (2.4) %.s −1 , in the prostaglandin E 1 group. We were unable to demonstrate significant between‐ or within‐group differences in dRoR. Thus, we conclude that nitroglycerin and prostaglandin E 1 do not attenuate dynamic cerebral autoregulation.