Comparison of intracarotid anesthetics for EEG silence.

Journal of Neurosurgical Anesthesiology
Shailendra JoshiErvant V Nishanian

Abstract

The goal of this study was to compare systemic and cerebrovascular effects of three anesthetic drugs (etomidate, thiopental, and propofol) when delivered by intracarotid and intravenous routes in doses that produce electrocerebral silence (electroencephalography [EEG]). EEG activity, mean arterial pressure (MAP), and laser Doppler flow as a proxy of cerebral blood flow (CBF) of 24 anesthetized New Zealand white rabbits were continuously recorded. Data were compared at three timepoints: baseline, during EEG silence, and after recovery of EEG activity. Drugs were randomly injected via the carotid artery to produce 10 minutes of EEG silence. After 30 minutes of rest, intravenous boluses of the same drug were injected to achieve 10 minutes of EEG silence. During EEG silence, transient hypotension was seen with intracarotid propofol, but there was no decrease in CBF. MAP and CBF did not decrease with either intracarotid etomidate or thiopental during EEG silence. Intracarotid/intravenous dose ratio of propofol (26%+/-22%; n=8, P<0.02) was much higher than that of etomidate and thiopental (14%+/-2% and 19%+/-11%, respectively; NS). Collectively, these results suggest intracarotid etomidate and thiopental are more useful than propofol...Continue Reading

References

Dec 1, 1992·Acta Physiologica Scandinavica·Y Morita-TsuzukiJ E Hardebo
Jan 1, 1997·Critical Care Clinics·M A ChengR Tempelhoff
Apr 20, 2004·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Shailendra JoshiRoger Hartl

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Citations

Nov 2, 2011·Arquivos de neuro-psiquiatria·Pedro André KowacsMurilo Sousa de Meneses
Aug 15, 2014·Expert Review of Neurotherapeutics·Xiaojuan Zhao, Xuefeng Wang
Aug 23, 2008·Anesthesiology·Shailendra JoshiEugene Ornstein
Jul 20, 2007·Journal of Neuro-oncology·Shailendra JoshiRobert L Fine

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