S. Strebel et al., CEREBRAL VASOMOTOR RESPONSIVENESS TO CARBON-DIOXIDE IS PRESERVED DURING PROPOFOL AND MIDAZOLAM ANESTHESIA IN HUMANS, Anesthesia and analgesia, 78(5), 1994, pp. 884-888
Carbon dioxide reactivity, as measured by transcranial Doppler ultraso
nography, was determined during total intravenous anesthesia with prop
ofol or midazolam in comparison with an awake control group. Thirty AS
A physical status I neurosurgical patients undergoing lumbar laminecto
my participated in the study. In randomized order they were subjected
to a CO2 reactivity challenge, either under an intravenous anesthesia
technique or in the awake state. CO2 reactivity was calculated in each
study group as a relative change in middle cerebral artery (MCA) flow
velocity per mm Hg change in end-tidal CO2 (PETCO(2)) (%/mm Hg). The
cerebrovascular response to changes in CO2 was preserved during intrav
enous anesthesia. There was a significant difference (P < 0.05) in the
reactivity slopes between the awake and the anesthetized patients wit
h a small but not significant difference between the propofol and the
midazolam group. We conclude that hypocarbia is effective in reducing
cerebral blood flow velocity (CBFV) during intravenous anesthesia, eit
her with propofol or midazolam.