Influence of blood pressure on internal carotid artery blood flow during combined propofol-remifentanil and thoracic epidural anesthesia

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Standard

Influence of blood pressure on internal carotid artery blood flow during combined propofol-remifentanil and thoracic epidural anesthesia. / Olesen, Niels D.; Egesborg, Astrid H.; Frederiksen, Hans-Jorgen; Kitchen, Carl-Christian; Svendsen, Lars B.; Olsen, Niels; Secher, Niels H.

I: Journal of Anaesthesiology Clinical Pharmacology, Bind 38, Nr. 4, 2022, s. 580-587.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt

Harvard

Olesen, ND, Egesborg, AH, Frederiksen, H-J, Kitchen, C-C, Svendsen, LB, Olsen, N & Secher, NH 2022, 'Influence of blood pressure on internal carotid artery blood flow during combined propofol-remifentanil and thoracic epidural anesthesia', Journal of Anaesthesiology Clinical Pharmacology, bind 38, nr. 4, s. 580-587. https://doi.org/10.4103/joacp.JOACP_575_20

APA

Olesen, N. D., Egesborg, A. H., Frederiksen, H-J., Kitchen, C-C., Svendsen, L. B., Olsen, N., & Secher, N. H. (2022). Influence of blood pressure on internal carotid artery blood flow during combined propofol-remifentanil and thoracic epidural anesthesia. Journal of Anaesthesiology Clinical Pharmacology, 38(4), 580-587. https://doi.org/10.4103/joacp.JOACP_575_20

Vancouver

Olesen ND, Egesborg AH, Frederiksen H-J, Kitchen C-C, Svendsen LB, Olsen N o.a. Influence of blood pressure on internal carotid artery blood flow during combined propofol-remifentanil and thoracic epidural anesthesia. Journal of Anaesthesiology Clinical Pharmacology. 2022;38(4):580-587. https://doi.org/10.4103/joacp.JOACP_575_20

Author

Olesen, Niels D. ; Egesborg, Astrid H. ; Frederiksen, Hans-Jorgen ; Kitchen, Carl-Christian ; Svendsen, Lars B. ; Olsen, Niels ; Secher, Niels H. / Influence of blood pressure on internal carotid artery blood flow during combined propofol-remifentanil and thoracic epidural anesthesia. I: Journal of Anaesthesiology Clinical Pharmacology. 2022 ; Bind 38, Nr. 4. s. 580-587.

Bibtex

@article{e03e9176b82044a18c88a2766a7e0a18,
title = "Influence of blood pressure on internal carotid artery blood flow during combined propofol-remifentanil and thoracic epidural anesthesia",
abstract = "Background and Aims: Anesthesia often reduces mean arterial pressure (MAP) to a level that may compromise cerebral blood flow. We evaluated whether phenylephrine treatment of anesthesia-induced hypotension affects internal carotid artery (ICA) blood flow and whether anesthesia affects ICA flow and CO2 reactivity.Material and Methods: The study included twenty-seven patients (65 +/- 11 years; mean +/- SD) undergoing esophageal resection (n = 14), stomach resection (n = 12), or a gastroentero anastomosis (n = 1) during combined propofol-remifentanil and thoracic epidural anesthesia. Duplex ultrasound evaluated ICA blood flow. Evaluations were before and after induction of anesthesia, before and after the administration of phenylephrine as part of standard care to treat anesthesia-induced hypotension at a MAP below 60 mmHg, and the hypocapnic reactivity of ICA flow was determined before and during anesthesia.Results: Induction of anesthesia reduced MAP from 108 +/- 12 to 66 +/- 16 mmHg (P < 0.0001) and ICA flow from 340 +/- 92 to 196 +/- 52 mL/min (P < 0.0001). Phenylephrine was administered to 24 patients (0.1-0.2 mg) and elevated MAP from 53 +/- 8 to 73 +/- 8 mmHg (P = 0.0001) and ICA flow from 191 +/- 43 to 218 +/- 50 mL/min (P = 0.0276). Furthermore, anesthesia reduced the hypocapnic reactivity of ICA flow from 23 (18-33) to 14%/kPa (10-22; P = 0.0068).Conclusion: Combined propofol-remifentanil and thoracic epidural anesthesia affect ICA flow and CO2 reactivity. Phenylephrine partly restored ICA flow indicating that anesthesia-induced hypotension contributes to the reduction in ICA flow.",
keywords = "Anesthesia, carotid artery, cerebrovascular circulation, hypotension, POSTOPERATIVE COGNITIVE DYSFUNCTION, OXYGEN-SATURATION, CARBON-DIOXIDE, HYPERTENSIVE PATIENTS, NONCARDIAC SURGERY, NITROUS-OXIDE, VELOCITY, AUTOREGULATION, REACTIVITY, CONSUMPTION",
author = "Olesen, {Niels D.} and Egesborg, {Astrid H.} and Hans-Jorgen Frederiksen and Carl-Christian Kitchen and Svendsen, {Lars B.} and Niels Olsen and Secher, {Niels H.}",
year = "2022",
doi = "10.4103/joacp.JOACP_575_20",
language = "English",
volume = "38",
pages = "580--587",
journal = "Journal of Anaesthesiology Clinical Pharmacology",
issn = "0970-9185",
publisher = "Journal of Anaesthesiology Clinical Pharmacology",
number = "4",

}

RIS

TY - JOUR

T1 - Influence of blood pressure on internal carotid artery blood flow during combined propofol-remifentanil and thoracic epidural anesthesia

AU - Olesen, Niels D.

AU - Egesborg, Astrid H.

AU - Frederiksen, Hans-Jorgen

AU - Kitchen, Carl-Christian

AU - Svendsen, Lars B.

AU - Olsen, Niels

AU - Secher, Niels H.

PY - 2022

Y1 - 2022

N2 - Background and Aims: Anesthesia often reduces mean arterial pressure (MAP) to a level that may compromise cerebral blood flow. We evaluated whether phenylephrine treatment of anesthesia-induced hypotension affects internal carotid artery (ICA) blood flow and whether anesthesia affects ICA flow and CO2 reactivity.Material and Methods: The study included twenty-seven patients (65 +/- 11 years; mean +/- SD) undergoing esophageal resection (n = 14), stomach resection (n = 12), or a gastroentero anastomosis (n = 1) during combined propofol-remifentanil and thoracic epidural anesthesia. Duplex ultrasound evaluated ICA blood flow. Evaluations were before and after induction of anesthesia, before and after the administration of phenylephrine as part of standard care to treat anesthesia-induced hypotension at a MAP below 60 mmHg, and the hypocapnic reactivity of ICA flow was determined before and during anesthesia.Results: Induction of anesthesia reduced MAP from 108 +/- 12 to 66 +/- 16 mmHg (P < 0.0001) and ICA flow from 340 +/- 92 to 196 +/- 52 mL/min (P < 0.0001). Phenylephrine was administered to 24 patients (0.1-0.2 mg) and elevated MAP from 53 +/- 8 to 73 +/- 8 mmHg (P = 0.0001) and ICA flow from 191 +/- 43 to 218 +/- 50 mL/min (P = 0.0276). Furthermore, anesthesia reduced the hypocapnic reactivity of ICA flow from 23 (18-33) to 14%/kPa (10-22; P = 0.0068).Conclusion: Combined propofol-remifentanil and thoracic epidural anesthesia affect ICA flow and CO2 reactivity. Phenylephrine partly restored ICA flow indicating that anesthesia-induced hypotension contributes to the reduction in ICA flow.

AB - Background and Aims: Anesthesia often reduces mean arterial pressure (MAP) to a level that may compromise cerebral blood flow. We evaluated whether phenylephrine treatment of anesthesia-induced hypotension affects internal carotid artery (ICA) blood flow and whether anesthesia affects ICA flow and CO2 reactivity.Material and Methods: The study included twenty-seven patients (65 +/- 11 years; mean +/- SD) undergoing esophageal resection (n = 14), stomach resection (n = 12), or a gastroentero anastomosis (n = 1) during combined propofol-remifentanil and thoracic epidural anesthesia. Duplex ultrasound evaluated ICA blood flow. Evaluations were before and after induction of anesthesia, before and after the administration of phenylephrine as part of standard care to treat anesthesia-induced hypotension at a MAP below 60 mmHg, and the hypocapnic reactivity of ICA flow was determined before and during anesthesia.Results: Induction of anesthesia reduced MAP from 108 +/- 12 to 66 +/- 16 mmHg (P < 0.0001) and ICA flow from 340 +/- 92 to 196 +/- 52 mL/min (P < 0.0001). Phenylephrine was administered to 24 patients (0.1-0.2 mg) and elevated MAP from 53 +/- 8 to 73 +/- 8 mmHg (P = 0.0001) and ICA flow from 191 +/- 43 to 218 +/- 50 mL/min (P = 0.0276). Furthermore, anesthesia reduced the hypocapnic reactivity of ICA flow from 23 (18-33) to 14%/kPa (10-22; P = 0.0068).Conclusion: Combined propofol-remifentanil and thoracic epidural anesthesia affect ICA flow and CO2 reactivity. Phenylephrine partly restored ICA flow indicating that anesthesia-induced hypotension contributes to the reduction in ICA flow.

KW - Anesthesia

KW - carotid artery

KW - cerebrovascular circulation

KW - hypotension

KW - POSTOPERATIVE COGNITIVE DYSFUNCTION

KW - OXYGEN-SATURATION

KW - CARBON-DIOXIDE

KW - HYPERTENSIVE PATIENTS

KW - NONCARDIAC SURGERY

KW - NITROUS-OXIDE

KW - VELOCITY

KW - AUTOREGULATION

KW - REACTIVITY

KW - CONSUMPTION

U2 - 10.4103/joacp.JOACP_575_20

DO - 10.4103/joacp.JOACP_575_20

M3 - Journal article

C2 - 36778814

VL - 38

SP - 580

EP - 587

JO - Journal of Anaesthesiology Clinical Pharmacology

JF - Journal of Anaesthesiology Clinical Pharmacology

SN - 0970-9185

IS - 4

ER -

ID: 338352662