CBF and CMRO2 during continuous etomidate infusion supplemented with N2O and fentanyl in patients with supratentorial cerebral tumour. A dose-response study.
In 14 patients with supratentorial cerebral tumours with midline shift below 10 mm, CBF and CMRO2 were measured (Kety & Schmidt) during craniotomy. The anaesthesia was continuous etomidate infusion supplemented with nitrous oxide and fentanyl. The patients were divided into two groups. In Group 1 etomidate infusion of 30 micrograms kg-1 min-1 was used throughout the anaesthesia, and CBF and CMRO2 were measured twice. In this group CMRO2 (means +/- s.d.) averaged 2.31 +/- 0.43 ml O2 100 g-1 min-1 70 min after induction and 2.21 +/- 0.38 ml O2 100 g-1 min-1 130 min after induction. In Group 2 the etomidate infusion was increased from 30 to 60 micrograms kg-1 min-1 after the first study and a significant fall in CMRO2 from 2.52 +/- 0.56 to 1.76 +/- 0.40 ml O2 100 g-1 min-1 was found. Simultaneously, a significant fall in CBF was observed. The CO2 reactivity was preserved during anaesthesia.
D000328:Adult; D000368:Aged; D000777:Anesthetics / Q000494:pharmacology*; D001921:Brain / Q000378:metabolism*; D001932:Brain Neoplasms / Q000378:metabolism* / Q000556:secondary / Q000601:surgery; D002245:Carbon Dioxide / Q000097:blood; D002560:Cerebrovascular Circulation / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D005045:Etomidate / Q000494:pharmacology*; D005260:Female; D005283:Fentanyl / Q000494:pharmacology*; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology*; D008297:Male; D008579:Meningioma / Q000378:metabolism / Q000601:surgery; D008875:Middle Aged; D009609:Nitrous Oxide / Q000494:pharmacology*; D009837:Oligodendroglioma / Q000378:metabolism / Q000601:surgery; D010101:Oxygen Consumption / Q000187:drug effects
D000777:Anesthetics; D007093:Imidazoles; D002245:Carbon Dioxide; D009609:Nitrous Oxide; D005283:Fentanyl; D005045:Etomidate