Hinohara H, Kadoi Y, Takahashi KI, Saito S, Goto F. Cerebrovascular carbon dioxide reactivity with propofol anesthesia in patients with previous stroke.
J Clin Anesth 2004;
16:483-7. [PMID:
15590249 DOI:
10.1016/j.jclinane.2003.11.001]
[Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2003] [Revised: 11/20/2003] [Accepted: 11/20/2003] [Indexed: 11/28/2022]
Abstract
STUDY OBJECTIVE
To examine whether patients with previous stroke have impaired cerebrovascular carbon dioxide (CO2) reactivity when receiving propofol anesthesia.
DESIGN
Prospective, controlled study.
SETTING
University hospital.
PATIENTS
34 consecutive patients, 17 of whom had previous stroke and were scheduled for elective cardiac surgery, and 17 control age-matched patients without previous stroke who were also scheduled for cardiac surgery.
INTERVENTIONS
Anesthesia was induced and a 2.5-MHz pulsed transcranial Doppler probe was attached to the patient's head at the right temporal window. Mean blood flow velocity of the middle cerebral artery (Vmca) was measured continuously.
MEASUREMENTS
After establishing baseline Vmca, arterial blood gases and cardiovascular hemodynamic values, partial pressure of end-tidal CO2 (PETCO2) was increased by changing the ventilatory frequency by 2 to 5 breaths/min. The measurements were repeated when PETCO2 increased and remained stable for 5 to 10 minutes.
MAIN RESULTS
Values for absolute CO2 reactivity in the control patients and in those with previous stroke were 2.6 +/- 0.5 and 2.9 +/- 0.7 cm/sec/mmHg, respectively, a nonsignificant difference in these values. Values for relative CO2 reactivity in control patients and in patients with previous stroke were 6.4 +/- 1.4 and 6.1 +/- 1.4%/mmHg, respectively, with no significant difference noted.
CONCLUSIONS
Cerebrovascular CO2 reactivity in patients with previous stroke is normal during propofol anesthesia.
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