Abstract:
:This experiment was designed to study the effect of progressively increasing blood propofol concentrations on cerebral blood flow (CBF), cerebral metabolic rate for oxygen (CMRO2), and the electroencephalogram (EEG). Nine New Zealand White rabbits were anesthetized with morphine (10 mg kg bolus and 2 mg/kg/h infusion) and 70% N2O. Both normothermia and normocarbia were maintained throughout the study. A 300 mum diameter platinum electrode and a 20 gauge sampling needle were inserted into the confluence of venous sinuses to permit the measurement of forebrain CBF and CMRO2. Cerebral blood flow was determined using the H2 clearance method and CMRO2 was calculated as CBF x arteriovenous O2 content difference. A single bifrontal EEG signal was also recorded. After baseline data were collected, a propofol infusion was begun, and the dose increased in a stepwise fashion from 0.28 to 1.11 mg/kg/min over 90 min (total dose 62.6 mg/kg). Every 22.5 min CBF, CMRO2, and EEG were recorded and arterial blood was sampled for the determination of propofol concentrations (by high-performance liquid chromatography). Angiotensin II was used to maintain mean arterial pressure >/=80 mm Hg. Eight animals completed the protocol. Blood propofol concentrations rose progressively in all animals, reaching a mean of 34 +/- 12 microg/ml (+/-SD) at the end of 90 min. Electroencephalogram changes during the early stages of the infusion were extremely variable. However, concentrations above approximately 20 microg/ml were associated with progressive EEG suppression, and isoelectricity developed in two animals, at blood concentrations of 41 and 52 microg/ml. There was a progressive dose-related decrease in CBF, which reached a value of approximately 62% of baseline at a concentration of 40 microg/ml (as predicted by a polynomial curve fitted to a plot of CBF versus blood concentration). The CMRO2 also decreased progressively, reaching approximately 57% of baseline at 40 microg/ml. A plot of CMRO2 versus EEG total power suggests that isoelectricity should be associated with a CMRO2 approximately equal to 53% of baseline. We conclude that propofol produces a dose-related decrease in CBF and CMRO2. The relationship between EEG suppression and CMRO2 is qualitatively similar to that seen with barbiturates.
journal_name
J Neurosurg Anesthesioljournal_title
Journal of neurosurgical anesthesiologyauthors
Ramani R,Todd MM,Warner DSdoi
10.1097/00008506-199204000-00006subject
Has Abstractpub_date
1992-04-01 00:00:00pages
110-9issue
2eissn
0898-4921issn
1537-1921pii
00008506-199204000-00006journal_volume
4pub_type
杂志文章abstract::Disseminated intravascular coagulation (DIC) is reported in neurosurgical patients; however, the incidence of DIC after craniotomy procedures is unknown. Using a surgical database, we identified 3164 patients who underwent primary craniotomy at Mayo Clinic Rochester between January 1, 2000 and December 31, 2004. Poten...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e318155b1c4
更新日期:2008-01-01 00:00:00
abstract::Clearance of valproic acid from brain tissue is believed to occur via a carrier-mediated system(s). The present study was designed to determine whether clearance was capacity-limited (saturable) and whether it occurred primarily at the choroid plexus. Ten rabbits were anesthetized with halothane and surgically prepare...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199407000-00008
更新日期:1994-07-01 00:00:00
abstract::Inflammatory response with cytokine release is reported to correlate with clinical outcome after aneurysmal subarachnoid hemorrhage (SAH). In selected cases, hypothermia and barbiturate coma are applied as means for neuroprotection after severe SAH. Hypothermia and high-dose barbiturate are reported to attenuate the i...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e31817996bf
更新日期:2008-07-01 00:00:00
abstract::Recently, the enzyme cyclooxygenase (COX) has been recognized to exist as constitutive (COX-1) and inducible isoforms (COX-2). In previous studies, drugs that were inhibitors of both COX-1 and COX-2 failed to decrease brain edema formation or improve Neurological Severity Score (NSS) after closed head trauma (CHT), al...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200001000-00009
更新日期:2000-01-01 00:00:00
abstract::Motor evoked potentials (MEPs) after transcranial magnetic stimulation (TMS) have been examined in 12 monkeys under neuroleptanalgesia (NLA). Compound muscle action potentials were recorded from abductor policis brevis (APB) and gastroncnemius (GN) muscles contralateral to the stimulation site. After obtaining baselin...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199106000-00006
更新日期:1991-06-01 00:00:00
abstract::The cause of the awareness under general anesthesia often cannot be definitely determined from retrospective reviews of handwritten records, examinations of equipment, or interviews with clinicians. Failure to deliver the intended concentrations of anesthetic agents to the patient is one possible contributing cause fo...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e318139f7df
更新日期:2007-10-01 00:00:00
abstract::The aim of this study was to determine the influence of acute and chronic ethanol treatment on neurological outcome following head trauma in rats. Eight-two Sprague-Dawley rats were divided into 10 groups. Four groups received sham head trauma (surgical incision of the scalp but no trauma) and were treated with (A) no...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199704000-00003
更新日期:1997-04-01 00:00:00
abstract::The clinical effects, recovery characteristics, and costs of total intravenous anesthesia (TIVA), sevoflurane, and isoflurane anesthesia have been measured in various out-patient operations, but have not been evaluated in patients undergoing laminectomy or discectomy. In the current study, the authors assessed the hem...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00008506-200110000-00003
更新日期:2001-10-01 00:00:00
abstract::Patients receiving anticonvulsants such as phenytoin or carbamazepine may be resistant to neuromuscular blocking agents. The authors report the response to rapacuronium bromide (1.5 mg/kg) in two adult patients; one receiving phenytoin and the other receiving carbamazepine. In both patients, there was a delay in achie...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200107000-00011
更新日期:2001-07-01 00:00:00
abstract::Although cerebral monitoring during CPB remains primarily investigational, recent data support its clinical utility. In particular, it is cerebral metabolic monitoring that provides meaningful information in terms of preparing the brain for dhCPB and dhCA. Cerebral blood flow or cerebral blood flow velocity monitoring...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/00008506-199307000-00022
更新日期:1993-07-01 00:00:00
abstract:INTRODUCTION:The exposure of anesthesiologists to organ recovery procedures and the anesthetic technique used during organ recovery has not been systematically studied in the United States. METHODS:A retrospective cohort study was conducted on all adult and pediatric patients who were declared brain dead between Janua...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000683
更新日期:2020-03-06 00:00:00
abstract::The effects of PaCO2 and mean arterial pressure (MAP) on succinylcholine-induced changes in cerebrospinal fluid (CSF) pressure were examined in 31 dogs anesthetized with halothane (0.7% end-expired) and nitrous oxide (66% inspired) in oxygen. Group 1 (n = 9) received succinylcholine (1.5 mg/kg i.v.) without control of...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199003000-00002
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:We compared the effect of propofol and sevoflurane combined with remifentanil under comparable bispectral index (BIS) levels on transcranial electric motor-evoked potentials (TceMEPs) and somatosensory-evoked potentials (SSEPs) during brainstem surgery. MATERIALS AND METHODS:A total of 40 consecutive patien...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ANA.0000000000000157
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:In patients with severe brain injury, endotracheal suctioning (ETS) can increase intracranial pressure (ICP) and reduce cerebral perfusion pressure (CPP). The aim of this prospective, blinded clinical trial was to assess the effectiveness of aerosolized lidocaine to prevent increase of ICP induced by ETS in ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e31826a75b1
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) was used to establish predictors for 30-day postoperative complications following spine and cranial neurosurgery. MATERIALS AND METHODS:The ACS-NSQIP participant use files were queried for neurosurgical cases between ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000474
更新日期:2018-10-01 00:00:00
abstract::Episodes of arterial hypotension are associated with an increased mortality in head injury patients. Rapid infusion of sodium bicarbonate in such patients may cause hypotension and elevate intracranial pressure. Therefore, we examined the effects of tromethamine (THAM) versus bicarbonate on intracranial pressure and b...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199407000-00009
更新日期:1994-07-01 00:00:00
abstract::With an incidence of a patent foramen ovale in nearly one fourth of the normal population, neurosurgical procedures in the semi-sitting position are associated with the risk of paradoxical air embolism. The present study was undertaken to evaluate an anesthetic concept to detect a patent foramen ovale with the help of...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00008506-200410000-00003
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Microdialysis is used to determine the concentrations of substances in the extracellular fluid of tissues. To date, it has not been used to measure rocuronium concentrations in human muscle. We determined the ability of microdialysis to recover rocuronium from muscle interstitial tissue for the purpose of as...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e3181c80a68
更新日期:2010-04-01 00:00:00
abstract::Surgical clipping may cause stenosis of parent arteries or occlusion of perforating arteries in cerebral aneurysm surgery. To prevent postoperative motor deficits, motor-evoked potentials (MEPs) have been used. This enables to detect cerebral ischemia. However, the rate of false negatives (motor deficits with preserve...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e3181de4eae
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Intraoperative movements are marker of inadequate level of sedation and are undesirable during burr-hole surgery under monitored anesthesia care (MAC). It distracts surgeon, hinders surgical procedure, and may lead to iatrogenic complication. Dexmedetomidine has shown to provide excellent analgesia, cooperat...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000194
更新日期:2016-04-01 00:00:00
abstract::Using a rabbit model of intracranial hypertension, we studied the effects of infusion of phenylephrine on intracranial pressure (ICP) and cerebral perfusion pressure (CPP). Seven New Zealand white rabbits were anesthetized with isoflurane and normocapnia was maintained. An extradural balloon was used to raise ICP to 2...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200201000-00006
更新日期:2002-01-01 00:00:00
abstract::Fat embolism syndrome is a dire complication of long bone trauma. It is usually associated with neurological, hematological and respiratory involvement, the latter being the major cause of death. We present a case of severe fat embolism syndrome occurring 3 hours after a long bone injury, leading to permanent vegetati...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200007000-00004
更新日期:2000-07-01 00:00:00
abstract::The affect of L-644,711, an anion transport inhibitor, on ischemic brain injury and edema was investigated. Spontaneously hypertensive rats were given one of the following doses of intrathecal L-644,711 during 180 min of middle cerebral artery occlusion and 120 min of reperfusion: control, vehicle only; dose I, 100 mi...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199112000-00003
更新日期:1991-12-01 00:00:00
abstract::This report describes a sudden decrease in blood pressure after conservative treatment of acute intracranial hypertension. A 63-year-old woman with acute hydrocephalus after undergoing clipping of an aneurysm of the right supracerebellar artery developed increased intracranial pressure, necessitating surgical manageme...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199804000-00008
更新日期:1998-04-01 00:00:00
abstract::Obstructive hydrocephalus remains a problem, and improvements in fiberoptic technology have promoted interest in neuroendoscopic ventriculostomy (NTV) as an alternative to standard cerebrospinal fluid shunts. The present study assessed 210 pediatric NTVs performed between 1994 and 2004 in patients aged 2 months to 10 ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::The effects of flumazenil (a benzodiazepine antagonist) on autoregulation of cerebral blood flow (CBF) were examined in dogs receiving midazolam and in dogs not receiving midazolam. Both groups were anesthetized with halothane (0.3% end-expired) and nitrous oxide (66%) in oxygen. Auto-regulation of CBF was assessed by...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-198909000-00006
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:Hemodynamic instability and cardiovascular events heavily affect the prognosis of traumatic brain injury. Physiological signals are monitored to detect these events. However, the signals are often riddled with faulty readings, which jeopardize the reliability of the clinical parameters obtained from the sign...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000462
更新日期:2018-10-01 00:00:00
abstract:STUDY DESIGN:A prospective, randomized study in a large general hospital setting. BACKGROUND:During spinal surgery, monitoring motor-evoked potentials (MEPs) is a means of assessing the intraoperative integrity of corticospinal pathways. However, MEPs are known to be sensitive to the effects of anesthetic agents. OBJ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.ana.0000211007.94269.50
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Prolongation of the interval from the peak to the end of the T wave (Tp-Te) on a 12-lead electrocardiogram (ECG) is associated with ventricular arrhythmias. The aim of this study was to clarify associations between Tp-Te, Tp-Te/QT, and Tp-Te/rate-corrected QT (QTc) with clinical severity of subarachnoid hemo...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000624
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Remifentanil is an ultrashort-acting µ-opioid receptor agonist and is especially suitable for neuroanesthesia. We previously reported that general anesthesia with remifentanil for brain tumor resection was associated with lower postoperative mortality and shorter postoperative length of stay (LOS) when compa...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000039
更新日期:2014-10-01 00:00:00