Abstract
Cerebral blood flow and metabolism have been studied in 11 patients during general anaesthesia and hypotension induced with sodium nitroprusside in combination with captopril. Cerebral blood flow was measured, using a Novo Cerebrograph model 10A, after injection of 133 xenon into an arm vein. Arterial and venous blood samples were drawn to calculate cerebral metabolism, Captopril 1 mg · kg−1 orally was given one hour before induction of anaesthesia. The sodium nitroprusside doses ranged between 0.16 and 3.23 μg · kg−1 · min−1. Mean arterial pressure was reduced 26 per cent to 46 mmHg during hypotension. It is concluded that for the group as a whole there were no changes in CBF and CMRO2 during hypotension. In one patient, however, critical low CBF measurements were recorded during and after hypotension. This indicates the need for further studies concerning the cerebral haemodynamic consequences of captopril and SNP-induced hypotension.
Résumé
Nous présentons les mesures des métabolisme et flot sanguin cerebraux (CMRO2 et CBF) de II patients sous anesthésie générale et hypotension controlée par nitroprussiate de sodium et captopril. Pour le flot, nous avons utilisé un Novo Cerebrograph 10A, après injection intraveineuse de133xenon tandis que le métabolisme était calculé à partir d’échantillons sanguins veineux et artériels. Les patients prenaient le captopril à la dose de 1 mg · kg−1 PO une heure avant l’induction de l’anesthésie et ils ont requis des doses de nitroprussiate allant de 0.16 à 3.23 μg · kg−1 · min−1 pour abaisser leur pression artérielle moyenne de 26 pour cent jusqu’à 46 mmHg pendant la periode d’hypotension controlée. Nous n’ avons pas pu identifier pour l’ensemble du groupe de modification significative du CBF ou du CMRO2 avec l’hypotension, quoique dans un cas, le CBF était très faible pendant et après cette période. L’impact de l’hypotension au captopril et nitroprussiate sur l’hémodynamie cerebrate mérite done une étude plus poussée.
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Thomsen, L.J., Riisager, S., Jensen, K.A. et al. Cerebral blood flow and metabolism during hypotension induced with sodium nitroprusside and captopril. Can J Anaesth 36, 392–396 (1989). https://doi.org/10.1007/BF03005336
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DOI: https://doi.org/10.1007/BF03005336