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04.01.2019 | Original Research | Ausgabe 6/2019

Journal of Clinical Monitoring and Computing 6/2019

Effects of propofol versus sevoflurane on cerebral circulation time in patients undergoing coiling for cerebral artery aneurysm: a prospective randomized crossover study

Zeitschrift:
Journal of Clinical Monitoring and Computing > Ausgabe 6/2019
Autoren:
Tomoko Ishibashi, Satoshi Toyama, Kazunori Miki, Jun Karakama, Yoshikazu Yoshino, Satoru Ishibashi, Makoto Tomita, Shigeru Nemoto
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10877-018-00251-2) contains supplementary material, which is available to authorized users.
Prior Presentation: The work was presented in part at the 65th Annual Meeting of the Japanese Society of Anesthesiologists, Yokohama, May 18, 2018.

Abstract

Many neuroendovascular treatments are supported by real-time anatomical and visual hemodynamic assessments through digital subtraction angiography (DSA). Here we used DSA in a single-center prospective randomized crossover study to assess the intracranial hemodynamics of patients undergoing coiling for cerebral aneurysm (n = 15) during sevoflurane- and propofol-based anesthesia. Color-coded DSA was used to define time to peak density of contrast medium (TTP) at several intravascular regions of interest (ROIs). Travel time at a particular ROI was defined as the TTP at the selected ROI minus TTP at baseline position on the internal carotid artery (ICA). Travel time at the jugular bulb on the anterior–posterior view was defined as the cerebral circulation time (CCT), which was divided into four segmental circulation times: ICA, middle cerebral artery (MCA), microvessel, and sinus. When bispectral index values were kept between 40 and 60, CCT (median [interquartile range]) was 10.91 (9.65–11.98) s under propofol-based anesthesia compared with 8.78 (8.32–9.45) s under sevoflurane-based anesthesia (P < 0.001). Circulation times for the ICA, MCA, and microvessel segments were longer under propofol-based anesthesia than under sevoflurane-based anesthesia (P < 0.05 for all). Our results suggest that, relative to sevoflurane, propofol decreases overall cerebral perfusion.

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