Human middle cerebral artery flow velocity during controlled hypotension combined with hemodilution-transcranial Doppler study.
J Clin Anesth
; 17(3): 177-81, 2005 May.
Article
em En
| MEDLINE
| ID: mdl-15896583
ABSTRACT
STUDY OBJECTIVE:
To evaluate the effects of controlled hypotension combined with hemodilution on human middle cerebral artery flow velocity (Vmca) by transcranial Doppler ultrasonography.DESIGN:
Randomized prospective study.SETTING:
Inpatient surgery at Nagasaki Rosai Hospital. PATIENTS Thirty American Society of Anesthesiologists physical status I and II patients scheduled for total hip arthroplasty.INTERVENTIONS:
Anesthesia was maintained with nitrous oxide-oxygen (N(2)O-O(2)) and sevoflurane during normocapnia. Hemodilution was carried out after induction of anesthesia, in which blood was withdrawn then replaced with the same amount of hydroxyethyl starch to achieve a final hematocrit level of 32% (group A = mild hemodilution group, N = 15) or 24% (group B = moderate hemodilution group, N = 15). In both groups, controlled hypotension was induced with prostaglandin E(1) to maintain mean arterial pressure at approximately 55 mm Hg for 80 minutes. MEASUREMENTS AND MAINRESULTS:
Vmca and blood gas were measured before hemodilution, after hemodilution, 80 minutes after starting hypotension, and 60 minutes after recovery from hypotension. Vmca significantly increased in group A (+122%) and group B (+156%) after each hemodilution. In group B, Vmca was significantly greater than baseline values at 80 minutes after starting hypotension (+135%) and 60 minutes after recovery from hypotension (+140%).CONCLUSION:
The combination of moderate hemodilution, such as hematocrit value of 24%, and prostaglandin E(1)-induced hypotension would not impair middle cerebral artery flow during sevoflurane-N(2)O-O(2) anesthesia during normocapnia.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Velocidade do Fluxo Sanguíneo
/
Ultrassonografia Doppler Transcraniana
/
Artéria Cerebral Média
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Hemodiluição
/
Hipotensão Controlada
Tipo de estudo:
Clinical_trials
/
Observational_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2005
Tipo de documento:
Article