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Cerebral physiologic effects of burst suppression doses of propofol during nonpulsatile cardiopulmonary bypass. CNS Subgroup of McSPI.

Publication ,  Journal Article
Newman, MF; Murkin, JM; Roach, G; Croughwell, ND; White, WD; Clements, FM; Reves, JG
Published in: Anesth Analg
September 1995

Central nervous system (CNS) complications are common after cardiac surgery. Death due to cardiac causes has decreased, but the number of deaths due to CNS injury has increased. As a first stage in the evaluation of its cerebral protection potential, we evaluated the cerebral physiologic effects of burst suppression doses of propofol during nonpulsatile cardiopulmonary bypass. Thirty patients without history of cerebral vascular disease were randomized to two study groups: control group (n = 15) who received sufentanil and vecuronium, or propofol group (n = 15) who received the control anesthetic and propofol infused to maintain electroencephalogram (EEG) burst suppression. Catheters were placed in the radial artery and right jugular bulb for sampling of systemic arterial and jugular bulb venous blood. 133Xe clearance was used to determine cerebral blood flow (CBF) at the start of normothermic bypass, during stable hypothermia, and when rewarmed to 35-37 degrees C nasopharyngeal temperature. Pharmacologic burst suppression with propofol produced a statistically significant reduction in CBF, cerebral oxygen delivery (DO2), and cerebral metabolic rate (CMRO2) at each measurement interval (P < 0..05 vs control). Cerebral arterial venous oxygen difference (C(a-v)O2), and jugular bulb venous oxygen saturation (SJvO2) were not statistically different between groups, indicating maintenance of cerebral metabolic autoregulation (coupling). The reduction in CBF and CMRO2, prominent during the normothermic phases of cardiopulmonary bypass (CPB), indicates a potential for propofol to reduce cerebral exposure to the embolic load during CPB.

Duke Scholars

Published In

Anesth Analg

DOI

ISSN

0003-2999

Publication Date

September 1995

Volume

81

Issue

3

Start / End Page

452 / 457

Location

United States

Related Subject Headings

  • Respiratory Burst
  • Propofol
  • Postoperative Complications
  • Partial Pressure
  • Oxygen
  • Middle Aged
  • Male
  • Hypothermia, Induced
  • Humans
  • Female
 

Citation

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Newman, M. F., Murkin, J. M., Roach, G., Croughwell, N. D., White, W. D., Clements, F. M., & Reves, J. G. (1995). Cerebral physiologic effects of burst suppression doses of propofol during nonpulsatile cardiopulmonary bypass. CNS Subgroup of McSPI. Anesth Analg, 81(3), 452–457. https://doi.org/10.1097/00000539-199509000-00004
Newman, M. F., J. M. Murkin, G. Roach, N. D. Croughwell, W. D. White, F. M. Clements, and J. G. Reves. “Cerebral physiologic effects of burst suppression doses of propofol during nonpulsatile cardiopulmonary bypass. CNS Subgroup of McSPI.Anesth Analg 81, no. 3 (September 1995): 452–57. https://doi.org/10.1097/00000539-199509000-00004.
Newman MF, Murkin JM, Roach G, Croughwell ND, White WD, Clements FM, et al. Cerebral physiologic effects of burst suppression doses of propofol during nonpulsatile cardiopulmonary bypass. CNS Subgroup of McSPI. Anesth Analg. 1995 Sep;81(3):452–7.
Newman, M. F., et al. “Cerebral physiologic effects of burst suppression doses of propofol during nonpulsatile cardiopulmonary bypass. CNS Subgroup of McSPI.Anesth Analg, vol. 81, no. 3, Sept. 1995, pp. 452–57. Pubmed, doi:10.1097/00000539-199509000-00004.
Newman MF, Murkin JM, Roach G, Croughwell ND, White WD, Clements FM, Reves JG. Cerebral physiologic effects of burst suppression doses of propofol during nonpulsatile cardiopulmonary bypass. CNS Subgroup of McSPI. Anesth Analg. 1995 Sep;81(3):452–457.

Published In

Anesth Analg

DOI

ISSN

0003-2999

Publication Date

September 1995

Volume

81

Issue

3

Start / End Page

452 / 457

Location

United States

Related Subject Headings

  • Respiratory Burst
  • Propofol
  • Postoperative Complications
  • Partial Pressure
  • Oxygen
  • Middle Aged
  • Male
  • Hypothermia, Induced
  • Humans
  • Female