Greater peripheral blood flow but less bleeding with propofol versus sevoflurane during spine surgery: a possible physiologic model?

Spine
Andrea AlbertinGianfranco Fraschini

Abstract

Prospective, randomized, single blind. To compare the effects of sevoflurane and propofol on lumbar-paraspinal-muscles regional blood flow, as well as bleeding when controlled hypotension is used. Controlled hypotension is the technique of choice to reduce blood loss during spine surgery, but changes in blood flow occurring to lumbar paraspinal muscles during controlled hypotension with propofol and sevoflurane, as well as the entity of bleeding, are unknown. Blood flow was assessed by means of a laser Doppler flowmeter during the prehypotensive and hypotensive (defined as a 15% reduction of baseline mean arterial pressure) period in 28 patients (aged 28-73 years, American Society of Anesthesiologists (ASA) I-II) undergoing lumbar spine surgery. Patients were randomized to receive either sevoflurane or propofol as main anesthetic agent to achieve hypotension. At the end of the surgery, blood loss was calculated and intraoperative bleeding (Visual Analogue Scale ranging from 0 to 100) was evaluated by the surgeon. RESULTS.: Peripheral Blood flow was significantly greater in the propofol group both before and during the hypotensive period (median values of 32.7 FU vs. 7.7 and 38.5 FU vs. 10.5, respectively). Despite this fact, bl...Continue Reading

References

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Citations

Oct 12, 2012·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Anne SebastianiGunther Pestel
Dec 18, 2013·The Spine Journal : Official Journal of the North American Spine Society·Wonjung Hwang, Eunsung Kim
Jun 13, 2009·European Journal of Anaesthesiology·Gonzalo SirgoJordi Rello
Apr 19, 2011·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Kyotaro KoshikaYuzuru Kaneko
Oct 21, 2016·Anesthesia and Analgesia·Dafna WillnerFederico Bilotta
Jan 7, 2020·The British Journal of Surgery·A ShahA A Klein

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