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Cited by 276Anesthesia and Sedative AgentsAnesthesia and Neurotoxicity ResearchBiomedical and Chemical Research

The DOI matches its Crossref record; 43 of the 43 references it cites were found in a registry or an index.

Effects of Surgical Levels of Propofol and Sevoflurane Anesthesia on Cerebral Blood Flow in Healthy Subjects Studied with Positron Emission Tomography

Kaisti, Kaike K., Metsähonkala, Liisa, Teräs, Mika, Oikonen, Vesa, Aalto, Sargo, Jääskeläinen, Satu, Hinkka, Susanna, Scheinin, Harry·2002·Anesthesiology
DOI 10.1097/00000542-200206000-00015
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Abstract

Background: The authors report a positron emission tomography (PET) study on humans with parallel exploration of the dose-dependent effects of an intravenous (propofol) and a volatile (sevoflurane) anesthetic agent on regional cerebral blood flow (rCBF) using quantitative and relative (Statistical Parametric Mapping [SPM]) analysis. Methods: Using H(2)(15)O, rCBF was assessed in 16 healthy (American Society of Anesthesiologists [ASA] physical status I) volunteers awake and at three escalating drug concentrations: 1, 1.5, and 2 MAC/EC(50), or specifically, at either 2, 3, and 4% end-tidal sevoflurane (n = 8), or 6, 9, and 12 microg/ml plasma concentration of propofol (n = 8). Rocuronium was used for muscle relaxation. Results: Both drugs decreased the bispectral index and blood pressure dose-dependently. Comparison between adjacent levels showed that sevoflurane initially (0 vs. 1 MAC) reduced absolute rCBF by 36-53% in all areas, then (1 vs. 1.5 MAC) increased rCBF in the frontal cortex, thalamus, and cerebellum (7-16%), and finally (1.5 vs. 2 MAC) caused a dual effect with a 23% frontal reduction and a 38% cerebellar increase. In the propofol group, flow was also initially reduced by 62-70%, with minor further effects. In the SPM analysis of the "awake to 1 MAC/EC(50)" step, both anesthetic agents reduced relative rCBF in the cuneus, precuneus, posterior limbic system, and the thalamus or midbrain; additionally, propofol reduced relative rCBF in the parietal and frontal cortices. Conclusions: Both anesthetic agents caused a global reduction of rCBF (propofol > sevoflurane) at the 1 MAC/EC(50) level. The effect was maintained at higher propofol concentrations, whereas 2 MAC sevoflurane caused noticeable flow redistribution. Despite the marked global changes, SPM analysis enabled detailed localization of regions with the greatest relative decreases.

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Metadata

Authors
Kaisti, K. K., Metsähonkala, L., Teräs, M., Oikonen, V., Aalto, S., Jääskeläinen, S., Hinkka, S., & Scheinin, H.
Affiliations
  • Turku University Hospital (FI)
  • Child Neurologist; Department of Child Neurology.
  • Physicist.
  • Modeller.
  • Turku PET Centre (FI)
  • Statistician, Department of Biostatistics.
  • University of Turku (FI)
ORCID
Venue
Anesthesiology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2002-06-01
Volume
96
Issue
6
Pages
1358-1370
ISSN
0003-3022 (ISSN-L)
DOI
10.1097/00000542-200206000-00015
OpenAlex
W2036296234
Cited by
276
References
43
Citations by year
2026: 3 · 2025: 5 · 2024: 8 · 2023: 8 · 2022: 6 · 2021: 11 · 2020: 13 · 2019: 13 · 2018: 13 · 2017: 12 · 2016: 10 · 2015: 15 · 2014: 15 · 2013: 14 · 2012: 16
FWCI
15.28
Type
journal article
Language
en
Open access
closed
Locations
  • Anesthesiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
  • Life Sciences › Neuroscience › Developmental Neuroscience › Anesthesia and Neurotoxicity Research
  • Health Sciences › Medicine › Physiology (medical) › Biomedical and Chemical Research
Keywords
propofol, sevoflurane, regional cerebral blood flow, depth of anesthesia, bispectral index, cerebral blood flow redistribution, frontal cortex, cerebellum, thalamus, statistical parametric mapping, healthy volunteers, end-tidal sevoflurane, plasma propofol concentration, 15O-water PET
MeSH terms
Sevoflurane, Adult, Blood Pressure, Cerebrovascular Circulation, Dose-Response Relationship, Drug, Electroencephalography, Humans, Male, Methyl Ethers, Tomography, Emission-Computed, Propofol, Anesthetics, Inhalation, Anesthetics, Intravenous

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