[Improvement in oxygenation by alpha stimulant].
In a 59-year-old female with cerebral aneurysm, oxygenation improved after the administration of phenylephrine. She had suffered subarachnoid hemorrhage and operated on 6 month before for ruptured aneurysm. Clipping of an un-ruptured cerebral aneurysm was planned. Anesthesia was induced and maintained with propofol, fentanyl and vecuronium. PGE1 0.01 microgram.kg-1.min-1, diltiazem 0.5 microgram.kg-1.min-1 and nicorandil 4 mg.h-1 were administered continuously. Arterial blood gas analysis revealed poor oxygenation (PaO2 100 mmHg at FIO2 0.5 with PEEP 5 cmH2O) and phenylephrine 0.1-0.2 microgram.kg-1.min-1 was added. This improved oxygenation (PaO2 150 mmHg) and PaO2 decreased again after discontinuation of phenylephrine when the closure began. The improvement of oxygenation by phenylephrine is thought to be enhancement of hypoxic pulmonary vasoconstriction.
Sato
K
K
Department of Neuroanesthesia, Kohnan Hospital, Sendai 982-8523.
Kato
M
M
D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage* / Q000494:pharmacology; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery; D007430:Intraoperative Care; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption / Q000187:drug effects*; D010313:Partial Pressure; D010656:Phenylephrine / Q000008:administration & dosage* / Q000494:pharmacology; D011652:Pulmonary Circulation / Q000187:drug effects
D000316:Adrenergic alpha-Agonists; D010656:Phenylephrine; D010100:Oxygen