Cerebrovascular carbon dioxide reactivity with propofol anesthesia in patients with previous stroke.
OBJECTIVE
To examine whether patients with previous stroke have impaired cerebrovascular carbon dioxide (CO2) reactivity when receiving propofol anesthesia.


METHODS
Prospective, controlled study.


METHODS
University hospital.


METHODS
34 consecutive patients, 17 of whom had previous stroke and were scheduled for elective cardiac surgery, and 17 control age-matched patients without previous stroke who were also scheduled for cardiac surgery.


METHODS
Anesthesia was induced and a 2.5-MHz pulsed transcranial Doppler probe was attached to the patient's head at the right temporal window. Mean blood flow velocity of the middle cerebral artery (Vmca) was measured continuously.


METHODS
After establishing baseline Vmca, arterial blood gases and cardiovascular hemodynamic values, partial pressure of end-tidal CO2 (PETCO2) was increased by changing the ventilatory frequency by 2 to 5 breaths/min. The measurements were repeated when PETCO2 increased and remained stable for 5 to 10 minutes.


RESULTS
Values for absolute CO2 reactivity in the control patients and in those with previous stroke were 2.6 +/- 0.5 and 2.9 +/- 0.7 cm/sec/mmHg, respectively, a nonsignificant difference in these values. Values for relative CO2 reactivity in control patients and in patients with previous stroke were 6.4 +/- 1.4 and 6.1 +/- 1.4%/mmHg, respectively, with no significant difference noted.


CONCLUSIONS
Cerebrovascular CO2 reactivity in patients with previous stroke is normal during propofol anesthesia.
Hinohara
Hiroshi
H
Department of Intensive Care, Gunma University, Graduate School of Medicine, Gunma, Japan.
Kadoi
Yuji
Y
Takahashi
Ken-ichiro
K
Saito
Shigeru
S
Goto
Fumio
F
D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D001784:Blood Gas Analysis; D002245:Carbon Dioxide / Q000097:blood*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D017558:Elective Surgical Procedures; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000009:adverse effects*; D011446:Prospective Studies; D020521:Stroke / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D017585:Ultrasonography, Doppler, Transcranial
D018686:Anesthetics, Intravenous; D002245:Carbon Dioxide; D015742:Propofol