Phenylephrine but not ephedrine reduces frontal lobe oxygenation following anesthesia-induced hypotension

Peter Nissen; Patrice Brassard; Thomas Jørgensen; Niels Secher; Peter Nissen; Patrice Brassard; Thomas B Jørgensen; Niels H Secher

doi:10.1007/s12028-009-9313-x

Phenylephrine but not ephedrine reduces frontal lobe oxygenation following anesthesia-induced hypotension

Peter Nissen, Patrice Brassard, Thomas Jørgensen, Niels Secher, Peter Nissen, Patrice Brassard, Thomas B Jørgensen, Niels H Secher

79 Citations (Scopus)

Abstract

Background: Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (S_cO₂) following anesthesia-induced hypotension. Methods: Following induction of anesthesia by fentanyl (0.15 mg kg^-1) and propofol (2.0 mg kg^-1), 13 patients received phenylephrine (0.1 mg iv) and 12 patients received ephedrine (10 mg iv) to restore mean arterial pressure (MAP). Heart rate (HR), MAP, stroke volume (SV), cardiac output (CO), and frontal lobe oxygenation (S_cO₂) were registered. Results: Induction of anesthesia was followed by a decrease in MAP, HR, SV, and CO concomitant with an elevation in S_cO₂. After administration of phenylephrine, MAP increased (51 ± 12 to 81 ± 13 mmHg; P < 0.001; mean ± SD). However, a 14% (from 70 ± 8% to 60 ± 7%) reduction in S_cO₂ (P < 0.05) followed with no change in CO (3.7 ± 1.1 to 3.4 ± 0.9 l min^-1). The administration of ephedrine led to a similar increase in MAP (53 ± 9 to 79 ± 8 mmHg; P < 0.001), restored CO (3.2 ± 1.2 to 5.0 ± 1.3 l min^-1), and preserved S _cO₂. Conclusions: The utilization of phenylephrine to correct hypotension induced by anesthesia has a negative impact on S _cO₂ while ephedrine maintains frontal lobe oxygenation potentially related to an increase in CO.

Original language	English
Journal	Neurocritical Care
Volume	12
Issue number	1
Pages (from-to)	17-23
Number of pages	7
ISSN	1541-6933
DOIs	https://doi.org/10.1007/s12028-009-9313-x
Publication status	Published - 1 Feb 2010

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@article{60371fc0e3d811deba73000ea68e967b,

title = "Phenylephrine but not ephedrine reduces frontal lobe oxygenation following anesthesia-induced hypotension",

abstract = "Background: Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (ScO2) following anesthesia-induced hypotension. Methods: Following induction of anesthesia by fentanyl (0.15 mg kg-1) and propofol (2.0 mg kg-1), 13 patients received phenylephrine (0.1 mg iv) and 12 patients received ephedrine (10 mg iv) to restore mean arterial pressure (MAP). Heart rate (HR), MAP, stroke volume (SV), cardiac output (CO), and frontal lobe oxygenation (ScO2) were registered. Results: Induction of anesthesia was followed by a decrease in MAP, HR, SV, and CO concomitant with an elevation in ScO2. After administration of phenylephrine, MAP increased (51 ± 12 to 81 ± 13 mmHg; P < 0.001; mean ± SD). However, a 14% (from 70 ± 8% to 60 ± 7%) reduction in ScO2 (P < 0.05) followed with no change in CO (3.7 ± 1.1 to 3.4 ± 0.9 l min-1). The administration of ephedrine led to a similar increase in MAP (53 ± 9 to 79 ± 8 mmHg; P < 0.001), restored CO (3.2 ± 1.2 to 5.0 ± 1.3 l min-1), and preserved S cO2. Conclusions: The utilization of phenylephrine to correct hypotension induced by anesthesia has a negative impact on S cO2 while ephedrine maintains frontal lobe oxygenation potentially related to an increase in CO.",

author = "Peter Nissen and Patrice Brassard and Thomas J{\o}rgensen and Niels Secher and Peter Nissen and Patrice Brassard and J{\o}rgensen, {Thomas B} and Secher, {Niels H}",

year = "2010",

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doi = "10.1007/s12028-009-9313-x",

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T1 - Phenylephrine but not ephedrine reduces frontal lobe oxygenation following anesthesia-induced hypotension

AU - Nissen, Peter

AU - Brassard, Patrice

AU - Jørgensen, Thomas

AU - Secher, Niels

AU - Nissen, Peter

AU - Brassard, Patrice

AU - Jørgensen, Thomas B

AU - Secher, Niels H

PY - 2010/2/1

Y1 - 2010/2/1

N2 - Background: Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (ScO2) following anesthesia-induced hypotension. Methods: Following induction of anesthesia by fentanyl (0.15 mg kg-1) and propofol (2.0 mg kg-1), 13 patients received phenylephrine (0.1 mg iv) and 12 patients received ephedrine (10 mg iv) to restore mean arterial pressure (MAP). Heart rate (HR), MAP, stroke volume (SV), cardiac output (CO), and frontal lobe oxygenation (ScO2) were registered. Results: Induction of anesthesia was followed by a decrease in MAP, HR, SV, and CO concomitant with an elevation in ScO2. After administration of phenylephrine, MAP increased (51 ± 12 to 81 ± 13 mmHg; P < 0.001; mean ± SD). However, a 14% (from 70 ± 8% to 60 ± 7%) reduction in ScO2 (P < 0.05) followed with no change in CO (3.7 ± 1.1 to 3.4 ± 0.9 l min-1). The administration of ephedrine led to a similar increase in MAP (53 ± 9 to 79 ± 8 mmHg; P < 0.001), restored CO (3.2 ± 1.2 to 5.0 ± 1.3 l min-1), and preserved S cO2. Conclusions: The utilization of phenylephrine to correct hypotension induced by anesthesia has a negative impact on S cO2 while ephedrine maintains frontal lobe oxygenation potentially related to an increase in CO.

AB - Background: Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (ScO2) following anesthesia-induced hypotension. Methods: Following induction of anesthesia by fentanyl (0.15 mg kg-1) and propofol (2.0 mg kg-1), 13 patients received phenylephrine (0.1 mg iv) and 12 patients received ephedrine (10 mg iv) to restore mean arterial pressure (MAP). Heart rate (HR), MAP, stroke volume (SV), cardiac output (CO), and frontal lobe oxygenation (ScO2) were registered. Results: Induction of anesthesia was followed by a decrease in MAP, HR, SV, and CO concomitant with an elevation in ScO2. After administration of phenylephrine, MAP increased (51 ± 12 to 81 ± 13 mmHg; P < 0.001; mean ± SD). However, a 14% (from 70 ± 8% to 60 ± 7%) reduction in ScO2 (P < 0.05) followed with no change in CO (3.7 ± 1.1 to 3.4 ± 0.9 l min-1). The administration of ephedrine led to a similar increase in MAP (53 ± 9 to 79 ± 8 mmHg; P < 0.001), restored CO (3.2 ± 1.2 to 5.0 ± 1.3 l min-1), and preserved S cO2. Conclusions: The utilization of phenylephrine to correct hypotension induced by anesthesia has a negative impact on S cO2 while ephedrine maintains frontal lobe oxygenation potentially related to an increase in CO.

U2 - 10.1007/s12028-009-9313-x

DO - 10.1007/s12028-009-9313-x

M3 - Journal article

C2 - 19957053

SN - 1541-6933

VL - 12

SP - 17

EP - 23

JO - Neurocritical Care

JF - Neurocritical Care

IS - 1

ER -

Phenylephrine but not ephedrine reduces frontal lobe oxygenation following anesthesia-induced hypotension

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