Effects of subanaesthetic and anaesthetic doses of sevoflurane on regional cerebral blood flow in healthy volunteers. A positron emission tomographic study

L Schlünzen, M S Vafaee, G E Cold, M Rasmussen, J F Nielsen, A Gjedde

Research output: Chapter in Book/Report/Conference proceedingBook chapterResearchpeer-review

Abstract

BACKGROUND: We tested the hypothesis that escalating drug concentrations of sevoflurane are associated with a significant decline of cerebral blood flow in regions subserving conscious brain activity, including specifically the thalamus.

METHODS: Nine healthy human volunteers received three escalating doses using 0.4%, 0.7% and 2.0% end-tidal sevoflurane inhalation. During baseline and each of the three levels of anaesthesia one PET scan was performed after injection of . Cardiovascular and respiratory parameters were monitored and electroencephalography and bispectral index (BIS) were registered.

RESULTS: Sevoflurane decreased the BIS values dose-dependently. No significant change in global cerebral blood flow (CBF) was observed. Increased regional CBF (rCBF) in the anterior cingulate (17-21%) and decreased rCBF in the cerebellum (18-35%) were identified at all three levels of sedation compared to baseline. Comparison between adjacent levels sevoflurane initially (0 vs. 0.2 MAC) decreased rCBF significantly in the inferior temporal cortex and the lingual gyrus. At the next level (0.2 MAC vs. 0.4 MAC) rCBF was increased in the middle temporal cortex and in the lingual gyrus, and decreased in the thalamus. At the last level (0.4 MAC vs. 1 MAC) the rCBF was increased in the insula and decreased in the posterior cingulate, the lingual gyrus, precuneus and in the frontal cortex.

CONCLUSION: At sevoflurane concentrations at 0.7% and 2.0% a significant decrease in relative rCBF was detected in the thalamus. Interestingly, some of the most profound changes in rCBF were observed in structures related to pain processing (anterior cingulate and insula).

Original languageEnglish
Title of host publicationISBN
Number of pages9
Volume48
Publication dateNov 2004
Edition10
Pages1268-76
DOIs
Publication statusPublished - Nov 2004
SeriesActa Anaesthesiologica Scandinavica
ISSN0001-5172

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Regional Blood Flow
Electrons
Gyrus Cinguli
Electroencephalography
sevoflurane
Pharmaceutical Preparations

Keywords

  • Adult
  • Algorithms
  • Anesthetics, Inhalation/administration & dosage
  • Brain/diagnostic imaging
  • Cerebrovascular Circulation/drug effects
  • Dose-Response Relationship, Drug
  • Electroencephalography/drug effects
  • Female
  • Humans
  • Male
  • Methyl Ethers/administration & dosage
  • Positron-Emission Tomography
  • Sevoflurane
  • Thalamus/blood supply

Cite this

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title = "Effects of subanaesthetic and anaesthetic doses of sevoflurane on regional cerebral blood flow in healthy volunteers. A positron emission tomographic study",
abstract = "BACKGROUND: We tested the hypothesis that escalating drug concentrations of sevoflurane are associated with a significant decline of cerebral blood flow in regions subserving conscious brain activity, including specifically the thalamus.METHODS: Nine healthy human volunteers received three escalating doses using 0.4{\%}, 0.7{\%} and 2.0{\%} end-tidal sevoflurane inhalation. During baseline and each of the three levels of anaesthesia one PET scan was performed after injection of . Cardiovascular and respiratory parameters were monitored and electroencephalography and bispectral index (BIS) were registered.RESULTS: Sevoflurane decreased the BIS values dose-dependently. No significant change in global cerebral blood flow (CBF) was observed. Increased regional CBF (rCBF) in the anterior cingulate (17-21{\%}) and decreased rCBF in the cerebellum (18-35{\%}) were identified at all three levels of sedation compared to baseline. Comparison between adjacent levels sevoflurane initially (0 vs. 0.2 MAC) decreased rCBF significantly in the inferior temporal cortex and the lingual gyrus. At the next level (0.2 MAC vs. 0.4 MAC) rCBF was increased in the middle temporal cortex and in the lingual gyrus, and decreased in the thalamus. At the last level (0.4 MAC vs. 1 MAC) the rCBF was increased in the insula and decreased in the posterior cingulate, the lingual gyrus, precuneus and in the frontal cortex.CONCLUSION: At sevoflurane concentrations at 0.7{\%} and 2.0{\%} a significant decrease in relative rCBF was detected in the thalamus. Interestingly, some of the most profound changes in rCBF were observed in structures related to pain processing (anterior cingulate and insula).",
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author = "L Schl{\"u}nzen and Vafaee, {M S} and Cold, {G E} and M Rasmussen and Nielsen, {J F} and A Gjedde",
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Effects of subanaesthetic and anaesthetic doses of sevoflurane on regional cerebral blood flow in healthy volunteers. A positron emission tomographic study. / Schlünzen, L; Vafaee, M S; Cold, G E; Rasmussen, M; Nielsen, J F; Gjedde, A.

ISBN. Vol. 48 10. ed. 2004. p. 1268-76 (Acta Anaesthesiologica Scandinavica).

Research output: Chapter in Book/Report/Conference proceedingBook chapterResearchpeer-review

TY - CHAP

T1 - Effects of subanaesthetic and anaesthetic doses of sevoflurane on regional cerebral blood flow in healthy volunteers. A positron emission tomographic study

AU - Schlünzen, L

AU - Vafaee, M S

AU - Cold, G E

AU - Rasmussen, M

AU - Nielsen, J F

AU - Gjedde, A

PY - 2004/11

Y1 - 2004/11

N2 - BACKGROUND: We tested the hypothesis that escalating drug concentrations of sevoflurane are associated with a significant decline of cerebral blood flow in regions subserving conscious brain activity, including specifically the thalamus.METHODS: Nine healthy human volunteers received three escalating doses using 0.4%, 0.7% and 2.0% end-tidal sevoflurane inhalation. During baseline and each of the three levels of anaesthesia one PET scan was performed after injection of . Cardiovascular and respiratory parameters were monitored and electroencephalography and bispectral index (BIS) were registered.RESULTS: Sevoflurane decreased the BIS values dose-dependently. No significant change in global cerebral blood flow (CBF) was observed. Increased regional CBF (rCBF) in the anterior cingulate (17-21%) and decreased rCBF in the cerebellum (18-35%) were identified at all three levels of sedation compared to baseline. Comparison between adjacent levels sevoflurane initially (0 vs. 0.2 MAC) decreased rCBF significantly in the inferior temporal cortex and the lingual gyrus. At the next level (0.2 MAC vs. 0.4 MAC) rCBF was increased in the middle temporal cortex and in the lingual gyrus, and decreased in the thalamus. At the last level (0.4 MAC vs. 1 MAC) the rCBF was increased in the insula and decreased in the posterior cingulate, the lingual gyrus, precuneus and in the frontal cortex.CONCLUSION: At sevoflurane concentrations at 0.7% and 2.0% a significant decrease in relative rCBF was detected in the thalamus. Interestingly, some of the most profound changes in rCBF were observed in structures related to pain processing (anterior cingulate and insula).

AB - BACKGROUND: We tested the hypothesis that escalating drug concentrations of sevoflurane are associated with a significant decline of cerebral blood flow in regions subserving conscious brain activity, including specifically the thalamus.METHODS: Nine healthy human volunteers received three escalating doses using 0.4%, 0.7% and 2.0% end-tidal sevoflurane inhalation. During baseline and each of the three levels of anaesthesia one PET scan was performed after injection of . Cardiovascular and respiratory parameters were monitored and electroencephalography and bispectral index (BIS) were registered.RESULTS: Sevoflurane decreased the BIS values dose-dependently. No significant change in global cerebral blood flow (CBF) was observed. Increased regional CBF (rCBF) in the anterior cingulate (17-21%) and decreased rCBF in the cerebellum (18-35%) were identified at all three levels of sedation compared to baseline. Comparison between adjacent levels sevoflurane initially (0 vs. 0.2 MAC) decreased rCBF significantly in the inferior temporal cortex and the lingual gyrus. At the next level (0.2 MAC vs. 0.4 MAC) rCBF was increased in the middle temporal cortex and in the lingual gyrus, and decreased in the thalamus. At the last level (0.4 MAC vs. 1 MAC) the rCBF was increased in the insula and decreased in the posterior cingulate, the lingual gyrus, precuneus and in the frontal cortex.CONCLUSION: At sevoflurane concentrations at 0.7% and 2.0% a significant decrease in relative rCBF was detected in the thalamus. Interestingly, some of the most profound changes in rCBF were observed in structures related to pain processing (anterior cingulate and insula).

KW - Adult

KW - Algorithms

KW - Anesthetics, Inhalation/administration & dosage

KW - Brain/diagnostic imaging

KW - Cerebrovascular Circulation/drug effects

KW - Dose-Response Relationship, Drug

KW - Electroencephalography/drug effects

KW - Female

KW - Humans

KW - Male

KW - Methyl Ethers/administration & dosage

KW - Positron-Emission Tomography

KW - Sevoflurane

KW - Thalamus/blood supply

U2 - 10.1111/j.1399-6576.2004.00505.x

DO - 10.1111/j.1399-6576.2004.00505.x

M3 - Book chapter

VL - 48

SP - 1268

EP - 1276

BT - ISBN

ER -