title: Time course of changes in cerebral blood flow velocity after tourniquet deflation in patients with diabetes mellitus or previous stroke under sevoflurane anesthesia.
abstract: We observed an increase in mean middle cerebral artery blood flow velocity (V(mca)) after tourniquet deflation during orthopedic surgery under sevoflurane anesthesia in patients with diabetes mellitus or previous stroke. Eight controls, seven insulin-treated diabetic patients, and eight previous stroke patients were studied. Arterial blood pressure, heart rate, V(mca), arterial blood gases, and plasma lactate levels were measured every minute for 10 min after tourniquet release in all patients. V(mca) was measured using a transcranial Doppler probe. V(mca) in all three groups increased after tourniquet deflation, the increase lasting for 4 or 5 min. However, the degree of increase in V(mca) in the diabetic patients was smaller than that in the other two groups after tourniquet deflation (at 2 min after tourniquet deflation: control 58.5 ± 3.3, previous stroke 58.4 ± 4.6, diabetes 51.7 ± 2.3; P < 0.05 compared with the other two groups). In conclusion, the degree of increase in V (mca) in diabetic patients is smaller than that in controls and patients with previous stroke.
authors.affiliation: Division of Intensive Care, Gunma University Hospital, Maebashi, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hinohara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kadoi
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Takahashi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
authors.forename: Chikara
authors.initials: C
authors.lastname: Kawauchi
authors.forename: Akio
authors.initials: A
authors.lastname: Mizutani
mesh_terms: D000368:Aged; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation; D001783:Blood Flow Velocity / Q000502:physiology; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D056805:Consciousness Monitors; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007717:Knee / Q000601:surgery; D007866:Leg / Q000601:surgery; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000502:physiology; D019637:Orthopedic Procedures; D012121:Respiration, Artificial; D000077149:Sevoflurane; D020521:Stroke / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014111:Tourniquets; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane