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The effect of pneumoperitoneum and Trendelenburg position on acute cerebral blood flow–carbon dioxide reactivity under sevoflurane anaesthesia
Author(s) -
Choi S. H.,
Lee S. J.,
Rha K. H.,
Shin S. K.,
Oh Y. J.
Publication year - 2008
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.1365-2044.2008.05636.x
Subject(s) - trendelenburg position , anesthesia , medicine , supine position , pneumoperitoneum , sevoflurane , cerebral blood flow , trendelenburg , blood flow , surgery , cardiology , laparoscopy
Summary This study compared cerebral blood flow–carbon dioxide (CBF–CO 2 ) reactivities in the supine and modest Trendelenburg position under pnemoperitoneum during sevoflurane anaesthesia. After induction of anaesthesia in 25 patients, mechanical ventilation was adjusted to increase P a co 2 from 4.7 (T 1 ) to 6.0 kPa (T 2 ) in the supine position, and the change in jugular bulb oxygen saturation was measured as an index of CBF. Then, after establishment of pneumoperitoneum and 30° Trendelenburg position, the CO 2 step and measurement of CBF were repeated. The CBF–CO 2 reactivity was 7.5 (3.3) %.kPa −1 (% change in jugular bulb oxygen saturation per unit change in P a co 2 ) in the supine position and 6.8 (2.3) %.kPa −1 in the 30° Trendelenburg‐pneumoperitoneum condition (p = 0.086). We conclude that CBF–CO 2 reactivity is unchanged by the modest Trendelenburg position under pneumoperitoneum during sevoflurane anaesthesia.

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