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Changes in CMR O2 , EEG and concentration of etomidate in serum and brain tissue during craniotomy with continuous etomidate supplemented with N 2 O and fentanyl
Author(s) -
COLD G. E.,
ESKESEN V.,
ERIKSEN H.,
LYON B. BLATT
Publication year - 1986
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1986.tb02388.x
Subject(s) - etomidate , medicine , fentanyl , anesthesia , electroencephalography , cerebral blood flow , burst suppression , propofol , psychiatry
Fourteen patients with supratentorial cerebral tumours were anaesthetized with continuous etomidate infusion (30 or 60 μg kg ‐1 min ‐1 ) supplemented with N 2 O 67% and fentanyl. Peroperatively cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMR O2 ) were measured twice by the Kety and Schmidt method. Simultaneously with the CBF measurements, blood for serum etomidate was sampled and EEG was recorded in 2‐min periods in 12 patients. In 10 patients a brain biopsy for etomidate was taken peroperatively and correlated with the other data. The results indicate a dose‐dependant increase in scrum etomidate and brain tissue etomidate, a decrease in CMR o2 and suppression of EEG activity. In individual studies an increase in serum etomidate or a decrease in CMR o2 correlated to a suppression of the EEG activity, and vice versa . However, the wide variations in these relationships within and between patients make any conclusion regarding CMR o2 impossible from the EEG recording, infusion rate of etomidate or scrum concentration of etomidate.