Journal of anesthesia · 1999
Local cortical cerebral blood flow and response to carbon dioxide during anesthesia in patients with moyamoya disease.
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Yusa T, Yamashiro K
Аннотация
PURPOSE: The CO(2) reactivity of cortical cerebral vessels and local cortical blood flow (l-CoBF) were evaluated during anesthesia in patients with moyamoya disease who were undergoing revascularization surgery.
METHODS: Using laser-Doppler flowmetry, the CO(2) reactivity of cortical cerebral vessels and l-CoBF were measured continuously in five patients at the local surgical field of the middle cerebral artery (MCA) territory.
RESULTS: Local-CoBF values obtained during the normocapnic condition varied from site to site of gyrus in the MCA region (0-73 ml. 100 g(-1).min(-1)). Local-CoBF was maximal at 39-43 mmHg of the PaCO(2) range, and decreased above and below this range. The response of l-CoBF to CO(2) was larger at the sites where the maximal level was obtained during normocapnia. In two patients, l-CoBF decreased by about 50%, and remained law even 40 min after administration of acetazolamide.
CONCLUSION: In patients with moyamoya disease, l-CoBF values obtained during the normocapnic condition varied from site to site of gyrus, and not only hypocapnia but also hypercapnia decreased l-CoBF within the MCA region.
METHODS: Using laser-Doppler flowmetry, the CO(2) reactivity of cortical cerebral vessels and l-CoBF were measured continuously in five patients at the local surgical field of the middle cerebral artery (MCA) territory.
RESULTS: Local-CoBF values obtained during the normocapnic condition varied from site to site of gyrus in the MCA region (0-73 ml. 100 g(-1).min(-1)). Local-CoBF was maximal at 39-43 mmHg of the PaCO(2) range, and decreased above and below this range. The response of l-CoBF to CO(2) was larger at the sites where the maximal level was obtained during normocapnia. In two patients, l-CoBF decreased by about 50%, and remained law even 40 min after administration of acetazolamide.
CONCLUSION: In patients with moyamoya disease, l-CoBF values obtained during the normocapnic condition varied from site to site of gyrus, and not only hypocapnia but also hypercapnia decreased l-CoBF within the MCA region.