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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

The effects of sevoflurane and propofol on cerebral hemodynamics during intracranial tumors surgery under monitoring the depth of anesthesia

1
Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences
2
Department of Neurosurgery, Medical Academy, Lithuanian University of Health Sciences
3
Department of Physiology, Medical Academy, Lithuanian University of Health Sciences, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2010, 46(11), 743; https://doi.org/10.3390/medicina46110105
Received: 23 April 2010 / Accepted: 8 November 2010 / Published: 13 November 2010
Hemodynamic effects during cerebral tumor resection surgery under monitoring the depth of anesthesia and during recovery in sevoflurane- or propofol-anesthetized patients have not been previously compared. Objective. To compare cerebral hemodynamic changes using transcranial Doppler sonography during sevoflurane or propofol anesthesia under state entropy (SE) monitoring, and during recovery period.
Material and methods. In a randomized manner, 130 patients received sevoflurane (group T-S) or propofol (group T-P) to maintain SE at 40–50. Cerebral blood flow velocity (Vmean) in the middle cerebral artery was evaluated at baseline, after tracheal intubation, opening of the dura mater, tumor resection, skin closure, extubation, and two hours after extubation. Cerebrovascular resistance index (RAP), estimated cerebral perfusion pressure (eCPP), and cerebral blood flow index (CBFI) were calculated off-line.
Results.
During surgery SE was 40.6 (SD, 8.1) in the group T-S and 44.0 (SD, 7.4) in the group T-P. Blood pressure was significantly higher in the group T-P. Compared to the baseline, Vmean decreased by 16.6% and 23.5% in the groups T-S and T-P, respectively (P<0.05). RAP and eCPP were higher in the group T-P versus the group T-S: 28.9% and 5.2%, respectively, above the baseline for RAP (P<0.005) and 3.2% and 16.9% below the baseline for eCPP (P<0.005). CBFI was below the baseline by 20.1% and 24.0% in the groups T-S and T-P, respectively (P>0.05). After the extubation and 2 hours later, Vmean recovered comparably with no differences in RAP, eCPP, or CBFI between the two groups.
Conclusions.
At the comparable depth of anesthesia for intracranial tumors surgery and during recovery, sevoflurane had no major effect on cerebral circulation measured by transcranial Doppler sonography as compared with propofol. Our results add to current knowledge on the safety of sevoflurane in neuroanesthesia.
Keywords: cerebrovascular circulation; transcranial Doppler sonography; sevoflurane; propofol; intracranial tumors cerebrovascular circulation; transcranial Doppler sonography; sevoflurane; propofol; intracranial tumors
MDPI and ACS Style

Banevičius, G.; Rugytė, D.; Macas, A.; Tamašauskas, A.; Stankevičius, E. The effects of sevoflurane and propofol on cerebral hemodynamics during intracranial tumors surgery under monitoring the depth of anesthesia. Medicina 2010, 46, 743.

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