Effects of sevoflurane versus propofol on cerebrovascular reactivity to carbon dioxide during laparoscopic surgery

• Main Authors: Wang C (Author), Ni C (Author), Li G (Author), Li Y (Author), Tao L (Author), Li N (Author), Wang J (Author), Guo X (Author)
• Format: Book
• Published: Dove Medical Press, 2017-10-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Chunyi Wang,1,* Cheng Ni,1,* Gang Li,1 Yan Li,1 Liyuan Tao,2 Nan Li,2 Jun Wang,1 Xiangyang Guo1 1Department of Anesthesiology, 2Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China *These authors contributed equally to&nbsp;this work Purpose: Cerebrovascular reactivity to carbon dioxide (CVR-CO2) reflects cerebrovascular reserve capacity, which is important in many brain disorders, including cerebrovascular and Alzheimer&rsquo;s diseases. Meanwhile, there is a relationship between CVR-CO2 and cognitive function. Therefore, the study is aimed at investigating the effects of sevoflurane versus propofol on CVR-CO2 during laparoscopic surgery, as well as the role of CVR-CO2 on cognitive function during perioperative period.Patients and methods: Eighty-eight patients, aged 18&ndash;65 years undergoing elective laparoscopic cholecystectomy, were randomly assigned to group S and group P. The patients in group&nbsp;S were induced with propofol and maintained with sevoflurane. The patients in group&nbsp;P were induced and maintained with propofol (target-controlled infusion). Remifentanil was given to both groups. CVR-CO2 at baseline (before induction), before pneumoperitoneum and during pneumoperitoneum, as well as Mini-Mental State Examination scores at baseline and 24&nbsp;hours after surgery were recorded.Results: In group S, CVR-CO2 before and during pneumoperitoneum increased significantly compared with baseline (P<0.05). In group P, CVR-CO2 before pneumoperitoneum increased significantly (P<0.05), but CVR-CO2 during pneumoperitoneum was not different compared with baseline. In either group, there was no significant correlation between mean blood pressure and CVR-CO2 during surgery, and there was no significant difference between Mini-Mental State Examination scores at baseline and 24 hours after surgery.Conclusion: Sevoflurane could maintain CVR-CO2 at a higher level during pneumoperitoneum in surgery. Therefore, in patients with impaired cerebrovascular reserve capacity, inhaled anesthetic could be a priority strategy for anesthesia maintenance to improve the compensatory vasodilation ability of cerebral small vessels. Keywords: cerebrovascular reactivity to carbon dioxide, sevoflurane, propofol, pneumoperitoneum, Mini-Mental State Examination score

Item Description

1178-203X