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Contributions

Local cortical blood flow and oxygen consumption during isoflurane-induced hypotension

Results in patients undergoing intracranial aneurysm clipping

Steven Roth, MD, Stephen C. Jones, PHD, Zeyd Y. Ebrahim, MD, Harry Friel, MS and John R. Little, MD
Cleveland Clinic Journal of Medicine November 1989, 56 (8) 766-770;
Steven Roth
Department of General Anesthesia, The Cleveland Clinic Foundation
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Stephen C. Jones
Department of Cerebrovascular Research Laboratory, The Cleveland Clinic Foundation
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Zeyd Y. Ebrahim
Department of General Anesthesia, The Cleveland Clinic Foundation
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Harry Friel
Department of Cerebrovascular Research Laboratory, The Cleveland Clinic Foundation
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John R. Little
Department of Neurosurgery (J.R.L.), The Cleveland Clinic Foundation
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ABSTRACT

Cerebral cortical blood flow (ICoBF) and metabolic rate for oxygen (1CoMRO2) were studied in eight patients undergoing intracranial aneurysm clipping. The patients were anesthetized with fentanyl 10 μg/kg and 70% nitrous oxide combined with 30% oxygen. Hypotension was induced with isoflurane. A thermal diffusion probe was used to measure ICoBF, and arterial and cerebral venous blood samples were obtained for measurement of arterio-cerebral venous O2 content difference. Measurements were made prior to hypotension, during hypotension (to mean arterial pressure approximately 50 mmHg), and posthypotension. Mean ICoBF decreased from 69 ± 20 mL/100 g/min at normotension to 59 ± 13 mL/100 g/min during hypotension (P <.03, NS) and was 61 ± 18 mL/100 g/min upon return to normotension (all values mean ± 1 SD). The lCoMRO2 averaged 3.9 ± 1.6 mL/100 g/min and 3.1 ± 1.5 mL/100 g/min, respectively (P <.03, NS) for normotension v hypotension. Values for cerebral venous PO2 and O2 saturation also did not differ significantly between study periods. These results indicate that isoflurane-induced hypotension during fentanyl-nitrous oxide anesthesia allows maintenance of a constant ICoBF and oxygen delivery.

INDEX TERMS
  • Cerebral Aneurysm
  • Isoflurane
  • Received August 1988.
  • Accepted August 1989.
  • Copyright © 1989 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 56 (8)
Cleveland Clinic Journal of Medicine
Vol. 56, Issue 8
1 Nov 1989
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Local cortical blood flow and oxygen consumption during isoflurane-induced hypotension
Steven Roth, Stephen C. Jones, Zeyd Y. Ebrahim, Harry Friel, John R. Little
Cleveland Clinic Journal of Medicine Nov 1989, 56 (8) 766-770;

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Local cortical blood flow and oxygen consumption during isoflurane-induced hypotension
Steven Roth, Stephen C. Jones, Zeyd Y. Ebrahim, Harry Friel, John R. Little
Cleveland Clinic Journal of Medicine Nov 1989, 56 (8) 766-770;
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Keywords

  • Cerebral Aneurysm
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