Effect of arterial blood pressure on the arterial to end-tidal carbon dioxide difference during anesthesia induction in patients scheduled for craniotomy

Journal of Neurosurgical Anesthesiology
Teemu LuostarinenTomi Niemi

Abstract

Before obtaining results of arterial blood gas analysis in mechanically ventilated patients undergoing neurosurgery, the volume of ventilation is primarily adjusted according to endtidal CO2 (EtCO2). We characterized the impact of various arterial blood pressure changes on arterial PCO2 (PaCO2) to EtCO2 differences (PaCO2-EtCO2) in patients anesthetized for craniotomy. Seventy-two elective craniotomy patients were enrolled in this prospective study. Noninvasive blood pressure was measured before anesthesia induction. Anesthesia was induced with thiopental, rocuronium or suxamethonium, and fentanyl and was maintained with inhaled anesthetics or propofol and remifentanil. Volume-controlled ventilation was adjusted after intubation according to the clinical judgment. The first arterial blood gas analysis was taken just before the head pinning. Systolic, diastolic, and mean arterial blood pressures (MAP) and heart rate were registered after intubation every 5 minutes until the head pinning. PaCO2-EtCO2 correlated positively with percentage difference between MAP awake at arrival in operating room and during arterial CO2 determination (P=0.0008, r=0.388). In analysis according to a MAP decrease of less than 20% (n=17), 20% to 29% (n...Continue Reading

References

Jan 1, 1989·Journal of Clinical Anesthesia·L Van KeerT Lerut
Jan 1, 1987·Acta Anaesthesiologica Scandinavica·A J CarlssonL Bindslev
Jan 1, 1965·Acta Physiologica Scandinavica. Supplementum·E Häggendal, B Johansson
Dec 1, 1983·Anesthesia and Analgesia·D B RaemerR A Gabel
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Mar 1, 1996·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·R W WahbaS J Kleiman
Mar 24, 1998·Acta Anaesthesiologica Scandinavica·H GehringP Schmucker
Nov 25, 2003·Anesthesia and Analgesia·Marco RuscaLennart Magnusson
Oct 1, 1992·Journal of Neurosurgical Anesthesiology·G B Russell, J M Graybeal

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Citations

Mar 11, 2011·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak, William L Lanier
Sep 18, 2018·Anesthesia and Analgesia·Maximilian S SchaeferTanja Astrid Meyer-Treschan
Oct 8, 2021·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Ryan DavisMichael Maile

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