What question did this study set out to answer?

To determine the effects of desflurane on middle cerebral artery blood flow velocity with and without the addition of sufentanil and nitrous oxide during anaesthesia induction.

July 1, 1997European Journal of Anaesthesiology

Administration of sufentanil and nitrous oxide blunts cardiovascular effects of desflurane but does not prevent an increase in middle cerebral artery blood flow velocity

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Why the study?

Does the addition of sufentanil and nitrous oxide blunt the cardiovascular effects and prevent the increase in middle cerebral artery blood flow velocity caused by desflurane in ASA Grade I or II patients?

Population

18 ASA Grade I or II patients

Comparison

Induction of anaesthesia with etomidate and… vs Induction of anaesthesia with etomidate and…

Design

Other

Follow-up

9 minutes (during induction)

Authors

PTPeter H. TonnerKlinikum Leverkusen JSJens ScholzUniversitäres Kinderwunschzentrum Lübeck TKT. KrauseKrankenhaus Reinbek - Startseite

Discussion

Member takes

Implication

May not fully blunt desflurane-induced cerebral blood flow velocity increases despite systemic attenuation; leaves open optimal adjunct regimens in neuroanesthesia.

Key Points

To determine the effects of desflurane on middle cerebral artery blood flow velocity with and without the addition of sufentanil and nitrous oxide during anaesthesia induction.
Studied 18 ASA Grade I or II patients divided into two cohorts of n = 9 each.
Induced anaesthesia using intravenous etomidate and vecuronium alone (Group 1) or supplemented with intravenous sufentanil (0.3 µg kg⁻¹) and nitrous oxide (Group 2).
Administered desflurane incrementally at 0.5 MAC min⁻¹ to 1.5 MAC for 7 minutes while monitoring hemodynamics and middle cerebral artery blood flow velocity via transcranial Doppler ultrasonography.
In Group 1, desflurane increased heart rate to 108 ± 2 bpm (37% increase), mean arterial pressure to 114 ± 6 mmHg (33% increase), and cerebral blood flow velocity to 86 ± 7 cm s⁻¹ (69% increase).
In Group 2, systemic hemodynamic responses were blunted without significant alterations in heart rate or mean arterial pressure, yet cerebral blood flow velocity still rose significantly to 73 ± 5 cm s⁻¹ (59% increase).

Structured PICO

Population

18 ASA Grade I or II patients

Intervention

Induction of anaesthesia with etomidate and vecuronium intravenously, sufentanil (0.3 microgram kg-1 i.v.) and nitrous oxide, followed by desflurane administered in steps of 0.5 MAC min-1 until 1.5 MAC was reached and maintained for 7 min

Comparator

Induction of anaesthesia with etomidate and vecuronium intravenously, followed by desflurane administered in steps of 0.5 MAC min-1 until 1.5 MAC was reached and maintained for 7 min (without sufentanil and nitrous oxide)

Outcome

Cerebral blood flow (CBF) velocity in the middle cerebral artery (MCA) and haemodynamic variables (heart rate, mean arterial pressure)surrogate

While sufentanil and nitrous oxide can blunt the tachycardia and hypertension associated with desflurane induction, they do not prevent the potentially adverse increase in cerebral blood flow velocity.

Cite This Study

Tonner et al. (1997) studied this question.

synapsesocial.com/papers/6a90e356263aa8e25c73cada https://doi.org/10.1046/j.1365-2346.1997.00147.x

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Implication

May not fully blunt desflurane-induced cerebral blood flow velocity increases despite systemic attenuation; leaves open optimal adjunct regimens in neuroanesthesia.

Administration of sufentanil and nitrous oxide blunts cardiovascular effects of desflurane but does not prevent an increase in middle cerebral artery blood flow velocity

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Administration of sufentanil and nitrous oxide blunts cardiovascular effects of desflurane but does not prevent an increase in middle cerebral artery blood flow velocity

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider