DOI: 10.1097/01.sa.0000151205.53344.e2
,
Issn Print: 0039-6206
Publication Date: 2005/02/01
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Excerpt
(Anesth Analg, 98:1127-1132, 2004)
Department of Anesthesiology, Texas Tech University, Lubbock, TX.
The effects of desflurane and isoflurane on cerebral perfusion pressure (CPP), lumbar cerebrospinal fluid pressure (LCSFP), and mean arterial blood pressure were compared in patients anesthetized with desflurane or isoflurane who were undergoing craniotomy for supratentorial lesions. Emergence from anesthesia was also studied to ascertain whether neurological function could be assessed earlier after desflurane or isoflurane anesthesia. Thirty-six patients were randomly allocated to receive either desflurane or isoflurane for maintenance of anesthesia at 1.2 minimum alveolar concentration (MAC). Patients were hyperventilated (PaCO2, 30 ± 2 mm Hg) after baseline LCSFP was obtained by the subarachnoid catheter. At an MAC of 1.2, mean LCSFP was not different statistically between the 2 study groups either before or after hyperventilation. In addition, CPP was not markedly different between the groups. Finally, a patient's time to respond to commands was 50% shorter in the desflurane group (30 ± 36 minutes) (mean ± SD) when compared with the isoflurane group (72 ± 126 minutes) for an insignificant difference. In patients undergoing craniotomy for supratentorial mass lesions, desflurane and isoflurane have similar effects on CPP and mean arterial blood pressure; however, the former does not cause marked changes in LCSFP in the setting of hyperventilation.
