title: Effect of propofol and remifentanil on cerebral perfusion and oxygenation in pigs: a systematic review.
abstract: The objective of this review is to evaluate the existing literature with regard to the influence of propofol and remifentanil total intravenous anaesthesia (TIVA) on cerebral perfusion and oxygenation in healthy pigs. Anaesthesia has influence on cerebral haemodynamics and it is important not only in human but also in veterinary anaesthesia to preserve optimal regulation of cerebral haemodynamics. Propofol and remifentanil are widely used in neuroanaesthesia and are increasingly used in experimental animal studies. In translational models, the pig has advantages compared to small laboratory animals because of brain anatomy, metabolism, neurophysiological maturation, and cerebral haemodynamics. However, reported effects of propofol and remifentanil on cerebral perfusion and oxygenation in pigs have not been reviewed. An electronic search identified 99 articles in English. Title and abstract screening selected 29 articles for full-text evaluation of which 19 were excluded with reasons. Of the 10 peer-reviewed articles included for review, only three had propofol or remifentanil anaesthesia as the primary study objective and only two directly investigated the effect of anaesthesia on cerebral perfusion and oxygenation (CPO). The evidence evaluated in this systematic review is limited, not focused on propofol and remifentanil and possibly influenced by factors of potential importance for CPO assessment. In one study of healthy pigs, CPO measures were within normal ranges following propofol-remifentanil anaesthesia, and addition of a single remifentanil bolus did not affect regional cerebral oxygen saturation (rSO2). Even though the pool of evidence suggests that propofol and remifentanil alone or in combination have limited effects on CPO in healthy pigs, confirmative evidence is lacking.
authors.affiliation: Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, 16 Dyrlægevej, 1870, Frederiksberg C, Denmark. mailo@sund.ku.dk.
authors.forename: Mai Louise Grandsgaard
authors.initials: ML
authors.lastname: Mikkelsen
authors.affiliation: Department of Surgical Gastroenterology C, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, 2100, Copenhagen Ø, Denmark.
authors.forename: Rikard
authors.initials: R
authors.lastname: Ambrus
authors.affiliation: Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, 16 Dyrlægevej, 1870, Frederiksberg C, Denmark.
authors.forename: James Edward
authors.initials: JE
authors.lastname: Miles
authors.affiliation: Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, 16 Dyrlægevej, 1870, Frederiksberg C, Denmark.
authors.forename: Helle Harding
authors.initials: HH
authors.lastname: Poulsen
authors.affiliation: Department of Neuroanaesthesia, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, 2100, Copenhagen Ø, Denmark.|Department of Anaesthesia, Sealand Hospital, University of Copenhagen, 1 Lykkebækvej, 4600, Køge, Denmark.
authors.forename: Finn Borgbjerg
authors.initials: FB
authors.lastname: Moltke
authors.affiliation: Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, 16 Dyrlægevej, 1870, Frederiksberg C, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Eriksen
mesh_terms: D000818:Animals; D001921:Brain / Q000098:blood supply* / Q000187:drug effects*; D006993:Hypnotics and Sedatives / Q000494:pharmacology; D010100:Oxygen / Q000378:metabolism*; D010506:Periodicals as Topic; D010880:Piperidines / Q000494:pharmacology*; D015742:Propofol / Q000494:pharmacology*; D000077208:Remifentanil; D013552:Swine
chemical_list: D006993:Hypnotics and Sedatives; D010880:Piperidines; D000077208:Remifentanil; D010100:Oxygen; D015742:Propofol
keywords: Animal model; Brain; Neuroanaesthesia; Oxygenation; Perfusion; Pig; Propofol; Remifentanil