Effects of propofol on cerebral oxygenation and metabolism after head injury.
作者信息
Johnston A J, Steiner L A, Chatfield D A, Coleman M R, Coles J P, Al-Rawi P G, Menon D K, Gupta A K
机构信息
University of Cambridge Department of Anaesthesia, Box 93, Cambridge CB2 2QQ, UK.
出版信息
Br J Anaesth. 2003 Dec;91(6):781-6. doi: 10.1093/bja/aeg256.
BACKGROUND
Flow-metabolism coupling is thought to be deranged after traumatic brain injury, while the effects of propofol on flow-metabolism coupling are controversial. We have used a step increase in target plasma propofol concentration in head injured patients to explore flow-metabolism coupling in these patients.
METHODS
Ten patients with a moderate to severe head injury received a step increase in propofol target controlled infusion of 2 microg x ml(-1). Cerebral tissue gas measurements were recorded using a multimodal sensor, and regional chemistry was assessed using microdialysis. Arterial-jugular venous oxygen differences (AVDO(2)) were measured and all patients had cortical function monitoring (EEG).
RESULTS
The step increase in propofol led to a large increase in EEG burst-suppression ratio (0% (range 0-1.1) to 46.1% (range 0-61.7), P<0.05); however, this did not significantly change tissue gas levels, tissue chemistry, or AVDO(2).
CONCLUSIONS
Flow-metabolism coupling remains intact during a step increase in propofol after traumatic brain injury. The EEG burst-suppression induced by propofol after traumatic brain injury does not appear to be a useful therapeutic tool in reducing the level of regional ischaemic burden.
Zotero 插件