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Neurocritical Care
Published in: Neurocritical Care 1/2010

01-02-2010 | Original Article

Phenylephrine but not Ephedrine Reduces Frontal Lobe Oxygenation Following Anesthesia-Induced Hypotension

Authors: Peter Nissen, Patrice Brassard, Thomas B. Jørgensen, Niels H. Secher

Published in: Neurocritical Care | Issue 1/2010

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Abstract

Background

Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (ScO2) following anesthesia-induced hypotension.

Methods

Following induction of anesthesia by fentanyl (0.15 mg kg−1) and propofol (2.0 mg kg−1), 13 patients received phenylephrine (0.1 mg iv) and 12 patients received ephedrine (10 mg iv) to restore mean arterial pressure (MAP). Heart rate (HR), MAP, stroke volume (SV), cardiac output (CO), and frontal lobe oxygenation (ScO2) were registered.

Results

Induction of anesthesia was followed by a decrease in MAP, HR, SV, and CO concomitant with an elevation in ScO2. After administration of phenylephrine, MAP increased (51 ± 12 to 81 ± 13 mmHg; P < 0.001; mean ± SD). However, a 14% (from 70 ± 8% to 60 ± 7%) reduction in ScO2 (P < 0.05) followed with no change in CO (3.7 ± 1.1 to 3.4 ± 0.9 l min−1). The administration of ephedrine led to a similar increase in MAP (53 ± 9 to 79 ± 8 mmHg; P < 0.001), restored CO (3.2 ± 1.2 to 5.0 ± 1.3 l min−1), and preserved ScO2.

Conclusions

The utilization of phenylephrine to correct hypotension induced by anesthesia has a negative impact on ScO2 while ephedrine maintains frontal lobe oxygenation potentially related to an increase in CO.
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Metadata
Title
Phenylephrine but not Ephedrine Reduces Frontal Lobe Oxygenation Following Anesthesia-Induced Hypotension
Authors
Peter Nissen
Patrice Brassard
Thomas B. Jørgensen
Niels H. Secher
Publication date
01-02-2010
Publisher
Humana Press Inc
Published in
Neurocritical Care / Issue 1/2010
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-009-9313-x

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