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Neurocritical Care
Published in: Neurocritical Care 2/2019

01-10-2019 | Angiography | Original Work

Propofol/Remifentanil Anesthesia Might Not Alter the Middle Cerebral Artery Diameter by Digital Subtraction Angiography

Authors: Stefano Arrigoni-Marocco, Nicolas Engrand, Vittorio Civelli, Joaquim Mateo, Marc-Antoine Labeyrie, Jean-Pierre Saint-Maurice, Alexandre Mebazaa, Etienne Gayat, Emmanuel Houdart, Fabrice Vallée

Published in: Neurocritical Care | Issue 2/2019

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Abstract

Introduction

Transcranial Doppler (TCD) of the middle cerebral artery (MCA) enables the measurement of the mean blood velocity (MCAVm) and the estimation of the cerebral blood flow (CBF), provided that no significant changes occur in the MCA diameter (MCADiam). Previous studies described a decrease in the MCAVm associated with the induction of total intravenous anesthesia (TIVA) by propofol and remifentanil. This decrease in blood velocity might be interpreted as a decrease in the CBF only where the MCADiam is not modified across TCD examinations.

Methods

In this observational study, we measured the MCADiam of 24 subjects (almost exclusively females) on digital subtraction angiography under awake and TIVA conditions.

Results

Across the two phases, we observed a decrease in the mean arterial blood pressure (from 84 ± 9 to 71 ± 6 mmHg; p < 0.001) and heart rate (76 ± 10 vs. 65 ± 8 beats/min; p < 0.001), and a concomitant decrease in the MCAVm (61 vs. 42 cm/s; p < 0.001). In contrast, the MCADiam did not vary in association with TIVA (2.3 ± 0.2 vs. 2.3 ± 0.2 mm; p = 0.52).

Conclusions

Those results suggested that in this population, no significant changes in the MCADiam are associated with TIVA.
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Metadata
Title
Propofol/Remifentanil Anesthesia Might Not Alter the Middle Cerebral Artery Diameter by Digital Subtraction Angiography
Authors
Stefano Arrigoni-Marocco
Nicolas Engrand
Vittorio Civelli
Joaquim Mateo
Marc-Antoine Labeyrie
Jean-Pierre Saint-Maurice
Alexandre Mebazaa
Etienne Gayat
Emmanuel Houdart
Fabrice Vallée
Publication date
01-10-2019
Publisher
Springer US
Published in
Neurocritical Care / Issue 2/2019
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-019-00699-3

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