[Hemodynamic studies on the vertebral artery system during the vertebral arterial surgery].
Few hemodynamic studies on the vertebral artery system in the human can be seen. The authors measured the vertebral arterial blood flow (VAF) with an electromagnetic flow meter in 45 patients who obtained vertebral arterial surgeries. The patients showing vertebrobasilar insufficiency such as vertigo and drop attack had serious kinking and stenosis at the first portion of the vertebral artery. The effects of induced hypotension by trimethaphan camsilate, induced hypertension by phenylephrine, cervical epidural anesthesia and induced hypertension under epidural anesthesia on the VAF were investigated. During the control state, mean systemic arterial blood pressure (SABP), mean VAF were 97 mmHg and 54 ml/min, respectively. The effects of varied SPBP were analyzed by (delta mean VAF/mean VAF)/(delta mean SABP/mean SABP), (delta V/delta S). The delta mean VAF and delta mean SABP indicated varied mean values of VAF and SABP, respectively. Mean SABP was varied significantly by about 25% in each method. The delta V/delta S in induced hypotension, induced hypertension, epidural anesthesia and induced hypertension under epidural anesthesia were -0.05, 0.07, 0.90 and 0.61, respectively, on the average. Induced hypotension by epidural anesthesia and induced hypertension under epidural anesthesia presented significant changes in mean VAF.(ABSTRACT TRUNCATED AT 250 WORDS)
Okada
Y
Y
Department of Neurosurgery, Chugoku Rousai Hospital, Kure, Japan.
Shima
T
T
Nishida
M
M
Yamada
T
T
Yamane
K
K
Fukui
T
T
Yoshida
A
A
D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006706:Homeostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010656:Phenylephrine / Q000627:therapeutic use; D012039:Regional Blood Flow; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014294:Trimethaphan / Q000627:therapeutic use; D014711:Vertebral Artery / Q000503:physiopathology* / Q000601:surgery; D014715:Vertebrobasilar Insufficiency / Q000503:physiopathology / Q000601:surgery*
D010656:Phenylephrine; D014294:Trimethaphan