Abstract
Background. Phenylephrine and ephedrine affect frontal lobe oxygenation (ScO2) differently when assessed by spatially resolved near infrared spectroscopy. We evaluated the effect of phenylephrine and ephedrine on extra- vs intra-cerebral blood flow and on ScO 2. Methods. In 10 healthy males (age 20-54 yr), phenylephrine or ephedrine was infused for an ~20 mm Hg increase in mean arterial pressure. Cerebral oxygenation (SavO2) was calculated from the arterial and jugular bulb oxygen saturations. Blood flow in the internal carotid artery (ICAf) and blood flow in the external carotid artery (ECAf) were assessed by duplex ultrasonography. Invos-5100c (SinvosO2) and Foresight (SforeO2) determined ScO 2 while forehead skin oxygenation (SskinO2) was assessed. Results. Phenylephrine reduced SforeO2 by 6.9% (95% confidence interval: 4.8-9.0%; P<0.0001), SinvosO2 by 10.5 (8.2-12.9%; P<0.0001), and ECAf (6-28%; P=0.0001), but increased ICAf (5-21%; P=0.003) albeit with no consequence for SskinO 2 or SavO2. In contrast, SforeO 2 was maintained with administration of ephedrine while S invosO2 and SavO2 decreased [by 3.1 (0.7-4.5%; P=0.017) and 2.1 (0.5-3.3%; P=0.012)] as arterial carbon dioxide pressure decreased (P=0.003). ICAf was stable and ECAf increased by 11 (4-18%; P=0.005) with administration of ephedrine while SskinO2 did not change. Conclusions. The effect of phenylephrine on ScO 2 is governed bya decrease in external carotid blood flow since it increases cerebral blood flow as determined by flow in the internal carotid artery. In contrast, ScO2 is largely maintained with administration of ephedrine because blood flow to extracerebral tissue increases.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | British Journal of Anaesthesia |
| Vol/bind | 113 |
| Udgave nummer | 3 |
| Sider (fra-til) | 452-8 |
| Antal sider | 7 |
| ISSN | 0007-0912 |
| DOI | |
| Status | Udgivet - sep. 2014 |