Cerebral hemodynamic response to the introduction of desflurane: A comparison with sevoflurane

Rapid increases in the inspired concentration of desflurane cause transient increases in heart rate and blood pressure. Desflurane also impairs cerebr al autoregulation at clinical concentrations. Sevoflurane does not share th ese hemodynamic side effects. We compared the cerebral and systemic hemodyn amic responses to the introduction of desflurane or sevoflurane after the i nduction of anesthesia with propofol. Twenty healthy adult patients schedul ed for nonneurological surgery were recruited. After the induction of anest hesia with propofol, either desflurane or sevoflurane (n = 10 per group) wa s introduced at 7.2% or 2.2%, respectively, and increased to 10.8% or 3.3%, respectively, 2 min later. Middle cerebral artery blood flow velocity was measured continuously by using a 2-MHz transcranial Doppler ultrasound prob e. Heart rate and blood pressure were recorded at I-min intervals during th e 12-min study period. Those patients receiving desflurane had significantl y greater middle cerebral artery blood flow velocities, heart rates, and bl ood pressures than those receiving sevoflurane (P < 0.01).