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Controlled Hypotension with Sodium Nitroprusside: Effects on Cerebral Blood Flow and Cerebral Venous Blood Gases in Patients Operated for Cerebral Aneurysms

1983; Wiley; Volume: 27; Issue: 1 Linguagem: Inglês

10.1111/j.1399-6576.1983.tb01906.x

1399-6576

L. HenriksenM.D., C Thorshauge, A Harmsen, Preben Christensen, M. Bredgaard Sørensen, J. Lester, Olaf B. Paulson,

Neurosurgical Procedures and Complications

The effect on cerebral haemodynamics of arterial hypotension induced by sodium nitroprusside infusion was studied in nine patients at the end of operations for intracranial aneurysms under N 2 O‐O 2 halothane anaesthesia. Cerebral blood flow (CBF), using the intraarteria 113 Xe injection method, and cerebral jugular venous blood gases were monitored before, during and after the induced hypotension. CBF and jugular venous oxygen tension (PvO 2 ) remained constant during the hypotensive period. Following its termination, a 13% increase in CBF occurred (P<0.05) and PvO 2 showed the same trend, a 5% increase (P<0.30). Regional CBF recordings (rCBF) in 16 small areas within the cerebral hemisphere were obtained at each measurement. In four of the patients, rCBF abnormalities were present in the form of hyperacmic regions, probably induced by the operation or the disease itself. The focal abnormalities were not accentuated during hypotension nor were ischaemic regions disclosed. It is concluded that sodium nitroprusside has only a minor influence on cerebral haemodynamics in the anaesthetized state.