Barbiturate anesthesia and brain proton spectroscopy

BACKGROUND AND PURPOSE: Thiopentone reduces CBF and metabolic rate. Still, it is widely used for sedation during MR spectroscopy. We investigated whet her barbiturate anesthesia and preanesthetic fasting have an effect on meta bolic ratios in proton MR spectroscopy of the brain. METHODS: Eight healthy, consenting, male volunteers were studied twice in a random, crossover fashion. The study sessions were conducted during fastin g (F) and nonfasting (nonF), with glucose infusion mimicking the fed state. During both sessions, two sets of spectroscopic data were collected, one d uring the awake state (F or nonF) and one under barbiturate anesthesia (F+B or nonF+B), using TEs of 135 and 270, Spectral areas of N-acetylaspartate (NAA), choline-containing compounds (Cho), and creatine plus phosphocreatin e (Cr) were calculated, and the presence of lactate or lipid was noted. Ven ous blood samples for glucose, beta-hydroxybutyrate, lactate, and electroly tes were collected. RESULTS: Barbiturate anesthesia caused a 42% reduction in blood lactate lev els during fasting, but not during glucose infusion. There were no differen ces in NAA/Cho, NAA/Cr, or in Cho/Cr between the groups F, nonF, F+B, or no nF+B. No lactate or lipid resonances were detected. CONCLUSION: Barbiturate anesthesia with preanesthetic fasting can be used f or proton spectroscopy at TEs of 135 or 270 without interference from NAA/C ho, NAA/Cr, or Cho/Cr or from the appearance of lactate or lipid.