Cortical blood flow response to hypercapnia during anaesthesia in Moyamoya disease.
Cortical blood flow (CoBF) was measured continuously by the laser-Doppler method to evaluate the effect of hypercapnia on cortical blood flow during ten surgical procedures in ten young patients (mean +/- SD 9.3 +/- 6.4 yr) with Moyamoya disease. The CoBF was 42.8 +/- 13.4 (ml.100 g-1.min-1) during normocapnia (PaCO2 = 39.0 +/- 2.4 mmHg), and 38.7 +/- 14.4 during hypercapnia (PaCO2 = 47.1 +/- 2.5 mmHg). There was a decrease in CoBF with hypercapnia (P < 0.05) so that the normal CoBF response to hypercapnia was impaired during surgery in the patients with Moyamoya disease. He concluded that patients with Moyamoya disease have a precarious cerebral circulation and hypercapnia may be detrimental to the cortical circulation. This suggests that normocapnia is preferable to hypercapnia in patients with Moyamoya disease during anaesthesia.
Kurehara
K
K
Department of Anaesthesiology, Osaka Neurological Institute, Japan.
Ohnishi
H
H
Touho
H
H
Furuya
H
H
Okuda
T
T
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D002245:Carbon Dioxide / Q000097:blood; D002536:Cerebral Arteries / Q000601:surgery; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000097:blood / Q000503:physiopathology*; D017078:Laser-Doppler Flowmetry; D008297:Male; D009072:Moyamoya Disease / Q000601:surgery*; D013699:Temporal Arteries / Q000601:surgery
D002245:Carbon Dioxide