title: The influence of nitroglycerin and prostaglandin E1 on dynamic cerebral autoregulation in adult patients during propofol and fentanyl anaesthesia.
abstract: We investigated dynamic cerebral autoregulation in 24 normocapnic adult patients during propofol and fentanyl anaesthesia. Hypotension was induced, to a mean arterial pressure (MAP) of 60-65 mmHg, using nitroglycerin or prostaglandin E1. Time-averaged mean cerebral blood flow velocity in the right middle cerebral artery was measured continuously using transcranial Doppler sonography. Dynamic autoregulatory response was activated by a sudden decrease in MAP following release of bilateral thigh cuffs (thigh cuff test) and evaluated as a dynamic rate of autoregulation (dRoR in % x s(-1)). The cuff test was repeated to obtain two values of dRoR during baseline and during induced hypotension; the data were then averaged. The mean value of dRoR during baseline and during induced hypotension was 14.2 (2.9) and 14.2 (1.6) % x s(-1), respectively, in the nitroglycerin group, and 14.6 (2.6) and 14.4 (2.4) % x s(-1), in the prostaglandin E1 group. We were unable to demonstrate significant between- or within-group differences in dRoR. Thus, we conclude that nitroglycerin and prostaglandin E1 do not attenuate dynamic cerebral autoregulation.
authors.affiliation: Department of Emergency & Critical Care Medicine, Niigata University Faculty of Medicine, 1-757 Asahimachi, Niigata 951-8520, Japan. endoh@med.niigata-u.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Endoh
authors.forename: T
authors.initials: T
authors.lastname: Honda
authors.forename: S
authors.initials: S
authors.lastname: Ohashi
authors.forename: S
authors.initials: S
authors.lastname: Hida
authors.forename: C
authors.initials: C
authors.lastname: Shibue
authors.forename: N
authors.initials: N
authors.lastname: Komura
mesh_terms: D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000494:pharmacology*; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000187:drug effects* / Q000502:physiology; D005260:Female; D005283:Fentanyl; D006706:Homeostasis / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000494:pharmacology*; D015742:Propofol; D014665:Vasodilator Agents / Q000494:pharmacology*
chemical_list: D018686:Anesthetics, Intravenous; D014665:Vasodilator Agents; D000527:Alprostadil; D005996:Nitroglycerin; D005283:Fentanyl; D015742:Propofol