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Desflurane increases brain tissue oxygenation and pH
Author(s) -
HOFFMAN W. E.,
CHARBEL F. T.,
EDELMAN G.
Publication year - 1997
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.1399-6576.1997.tb04859.x
Subject(s) - medicine , desflurane , oxygenation , anesthesia , propofol
Background Desflurane anesthesia can produce cerebral metabolic depression and increase cerebral blood flow. We evaluated the effect of desflurane on brain tissue oxygen pressure (PO 2 ), carbon dioxide pressure (PCO 2 ) and pH during neurosurgery. Methods: Following a craniotomy, the dura was opened and a Paratrend 7 sensor, which measures PO 2 , PCO 2 , pH and temperature, was inserted into brain tissue. In 6 control patients in group 1, anesthesia was maintained constant with 3% end‐tidal desflurane over 60 min, including a 30‐min stabilization period. In group 2, 9 patients were ventilated with 3% desflurane under baseline conditions. After a 30‐min stabilization period, baseline tissue gases and pH were measured and end‐tidal desflurane was increased to 6% and then 9% for 15‐min intervals. Mean arterial pressure (MAP) was maintained with intravenous phen‐ylephrine. Results: Under baseline conditions, cardiovascular and brain tissue measures were similar between the 2 groups. Increasing end‐tidal desflurane from 3% to 9% produced burst‐suppression EEG in all patients and significantly increased tissue PO 2 and pH and decreased PCO 2 . No parameters changed significantly in the control group during steady‐state anesthesia. Conclusion: These results show that 9% desflurane can improve brain tissue metabolic status before temporary brain artery occlusion if cerebral perfusion pressure is maintained. This may be particularly important in patients with symptoms of ischemia before surgery.