title: Sevoflurane and nitrous oxide increase regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV) in a drug-specific manner in human volunteers.
abstract: Anesthesia for diagnostic procedures, e.g., MRI measurements, has increasingly used sevoflurane and nitrous oxide in recent years. Sevoflurane and nitrous oxide are known cerebrovasodilatators, however, which potentially interferes with MRI examination of cerebral hemodynamics. To compare the effects of relevant equianesthetic concentrations (0.4 MAC) of both drugs on regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV) we used contrast-enhanced magnetic resonance imaging (MRI) perfusion measurement, which has the advantage of providing regional anatomic resolution. Sevoflurane increased rCBF more than did nitrous oxide in all regions except in parietal and frontal gray matter. Nitrous oxide, by contrast, increased rCBV in most of the gray matter regions more than did sevoflurane. In summary we show that, in contrast to nitrous oxide, sevoflurane supratentorially reversed the anterior-posterior gradient in rCBF and typically redistributed rCBF to infratentorial gray matter. In contrast, nitrous oxide increased rCBV more than did sevoflurane. Both inhalational anesthetics had a drug-specific influence on cerebral hemodynamics, which is of importance when interpreting MRI studies of cerebral hemodynamics in anesthetized patients.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, University of Innsbruck, Austria. christian.kolbitsch@uibk.ac.at
authors.forename: C
authors.initials: C
authors.lastname: Kolbitsch
authors.forename: I H
authors.initials: IH
authors.lastname: Lorenz
authors.forename: C
authors.initials: C
authors.lastname: Hörmann
authors.forename: C
authors.initials: C
authors.lastname: Kremser
authors.forename: M
authors.initials: M
authors.lastname: Schocke
authors.forename: S
authors.initials: S
authors.lastname: Felber
authors.forename: P L
authors.initials: PL
authors.lastname: Moser
authors.forename: M
authors.initials: M
authors.lastname: Hinteregger
authors.forename: K P
authors.initials: KP
authors.lastname: Pfeiffer
authors.forename: A
authors.initials: A
authors.lastname: Benzer
mesh_terms: D000328:Adult; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D001783:Blood Flow Velocity / Q000187:drug effects; D001810:Blood Volume / Q000187:drug effects*; D002560:Cerebrovascular Circulation / Q000187:drug effects* / Q000502:physiology*; D006801:Humans; D008738:Methyl Ethers / Q000494:pharmacology*; D009609:Nitrous Oxide / Q000494:pharmacology*; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide