Effect of phenylephrine and ephedrine bolus treatment on cerebral oxygenation in anaesthetized patients.

Published

Journal Article

BACKGROUND: How phenylephrine and ephedrine treatments affect global and regional haemodynamics is of major clinical relevance. Cerebral tissue oxygen saturation (Sct(O2) )-guided management may improve postoperative outcome. The physiological variables responsible for Sct(O2) changes induced by phenylephrine and ephedrine bolus treatment in anaesthetized patients need to be defined. METHODS: A randomized two-treatment cross-over trial was conducted: one bolus dose of phenylephrine (100-200 µg) and one bolus dose of ephedrine (5-20 mg) were given to 29 ASA I-III patients anaesthetized with propofol and remifentanil. , mean arterial pressure (MAP), cardiac output (CO), and other physiological variables were recorded before and after treatments. The associations of changes were analysed using linear-mixed models. RESULTS: The CO decreased significantly after phenylephrine treatment [▵CO = -2.1 (1.4) litre min(-1), P<0.001], but was preserved after ephedrine treatment [▵CO = 0.5 (1.4) litre min(-1), P>0.05]. The was significantly decreased after phenylephrine treatment [▵ = -3.2 (3.0)%, P<0.01] but preserved after ephedrine treatment [▵ = 0.04 (1.9)%, P>0.05]. CO was identified to have the most significant association with (P<0.001). After taking CO into consideration, the other physiological variables, including MAP, were not significantly associated with (P>0.05). CONCLUSIONS: Associated with changes in CO, decreased after phenylephrine treatment, but remained unchanged after ephedrine treatment. The significant correlation between CO and implies a cause-effect relationship between global and regional haemodynamics.

Full Text

Cited Authors

  • Meng, L; Cannesson, M; Alexander, BS; Yu, Z; Kain, ZN; Cerussi, AE; Tromberg, BJ; Mantulin, WW

Published Date

  • August 2011

Published In

Volume / Issue

  • 107 / 2

Start / End Page

  • 209 - 217

PubMed ID

  • 21642644

Pubmed Central ID

  • 21642644

Electronic International Standard Serial Number (EISSN)

  • 1471-6771

Digital Object Identifier (DOI)

  • 10.1093/bja/aer150

Language

  • eng

Conference Location

  • England