Phenylephrine but not Ephedrine Reduces Frontal Lobe Oxygenation Following Anesthesia-Induced Hypotension
Background Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (S c O 2 ) following anesthesia-induced hypotension. Methods Following induction of anesthesia by fentanyl (0.15 mg kg −1 ) and propofol...
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| Veröffentlicht in: | Neurocritical care 2010-02, Vol.12 (1), p.17-23 |
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| description | Background
Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (S
c
O
2
) following anesthesia-induced hypotension.
Methods
Following induction of anesthesia by fentanyl (0.15 mg kg
−1
) and propofol (2.0 mg kg
−1
), 13 patients received phenylephrine (0.1 mg iv) and 12 patients received ephedrine (10 mg iv) to restore mean arterial pressure (MAP). Heart rate (HR), MAP, stroke volume (SV), cardiac output (CO), and frontal lobe oxygenation (S
c
O
2
) were registered.
Results
Induction of anesthesia was followed by a decrease in MAP, HR, SV, and CO concomitant with an elevation in S
c
O
2
. After administration of phenylephrine, MAP increased (51 ± 12 to 81 ± 13 mmHg;
P
<
0.001; mean ± SD). However, a 14% (from 70 ± 8% to 60 ± 7%) reduction in S
c
O
2
(
P
<
0.05) followed with no change in CO (3.7 ± 1.1 to 3.4 ± 0.9 l min
−1
). The administration of ephedrine led to a similar increase in MAP (53 ± 9 to 79 ± 8 mmHg;
P
<
0.001), restored CO (3.2 ± 1.2 to 5.0 ± 1.3 l min
−1
), and preserved S
c
O
2
.
Conclusions
The utilization of phenylephrine to correct hypotension induced by anesthesia has a negative impact on S
c
O
2
while ephedrine maintains frontal lobe oxygenation potentially related to an increase in CO. |
| doi_str_mv | 10.1007/s12028-009-9313-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_746283362</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2919332512</sourcerecordid><originalsourceid>FETCH-LOGICAL-c403t-ea49a511fe2014763a52fcabc4f285e94b01a4a0c8c1770d23e79a0301eed4c03</originalsourceid><addsrcrecordid>eNp1kU2LFDEQhoMo7of-AC_S4MFTtPLVmRyXZcddGFgRPYd0unqml56kTbpx5t-b3hlYEDxVqDzvW0W9hHxg8IUB6K-ZceArCmCoEUzQwytyyZSqKZiavV7ektHaCHFBrnJ-AuDaaPWWXDBjlAYlLkn_fYfhOOC4S33AqpmnKsSpuht32D53fmA7e8zVOsUwuaHaxAarx8Nxi8FNfQzVOg5D_NOHbXUTME87zL2jD2FRtdX9cYwThlzAd-RN54aM78_1mvxa3_28vaebx28Ptzcb6iWIiaKTxinGOuTApK6FU7zzrvGy4yuFRjbAnHTgV55pDS0XqI0DAQyxlR7ENfl88h1T_D2Xjey-zx6HwQWMc7Za1nwlRM0L-ekf8inOKZTlLDesnI0rtlDsRPkUc07Y2TH1e5eOloFdYrCnGGyJwS4x2EPRfDw7z80e2xfF-e4F4Ccgl6-wxfQy-v-ufwETDpQd</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2919332512</pqid></control><display><type>article</type><title>Phenylephrine but not Ephedrine Reduces Frontal Lobe Oxygenation Following Anesthesia-Induced Hypotension</title><source>MEDLINE</source><source>ProQuest Central (Alumni Edition)</source><source>Springer Nature - Complete Springer Journals</source><source>ProQuest Central UK/Ireland</source><source>ProQuest Central</source><creator>Nissen, Peter ; Brassard, Patrice ; Jørgensen, Thomas B. ; Secher, Niels H.</creator><creatorcontrib>Nissen, Peter ; Brassard, Patrice ; Jørgensen, Thomas B. ; Secher, Niels H.</creatorcontrib><description>Background
Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (S
c
O
2
) following anesthesia-induced hypotension.
Methods
Following induction of anesthesia by fentanyl (0.15 mg kg
−1
) and propofol (2.0 mg kg
−1
), 13 patients received phenylephrine (0.1 mg iv) and 12 patients received ephedrine (10 mg iv) to restore mean arterial pressure (MAP). Heart rate (HR), MAP, stroke volume (SV), cardiac output (CO), and frontal lobe oxygenation (S
c
O
2
) were registered.
Results
Induction of anesthesia was followed by a decrease in MAP, HR, SV, and CO concomitant with an elevation in S
c
O
2
. After administration of phenylephrine, MAP increased (51 ± 12 to 81 ± 13 mmHg;
P
<
0.001; mean ± SD). However, a 14% (from 70 ± 8% to 60 ± 7%) reduction in S
c
O
2
(
P
<
0.05) followed with no change in CO (3.7 ± 1.1 to 3.4 ± 0.9 l min
−1
). The administration of ephedrine led to a similar increase in MAP (53 ± 9 to 79 ± 8 mmHg;
P
<
0.001), restored CO (3.2 ± 1.2 to 5.0 ± 1.3 l min
−1
), and preserved S
c
O
2
.
Conclusions
The utilization of phenylephrine to correct hypotension induced by anesthesia has a negative impact on S
c
O
2
while ephedrine maintains frontal lobe oxygenation potentially related to an increase in CO.</description><identifier>ISSN: 1541-6933</identifier><identifier>EISSN: 1556-0961</identifier><identifier>DOI: 10.1007/s12028-009-9313-x</identifier><identifier>PMID: 19957053</identifier><language>eng</language><publisher>New York: Humana Press Inc</publisher><subject>Adult ; Aged ; Anesthesia, General ; Blood ; Critical Care Medicine ; Ephedrine - administration & dosage ; Ephedrine - adverse effects ; Female ; Fentanyl ; Flow velocity ; Frontal Lobe - blood supply ; Frontal Lobe - drug effects ; Hemodynamics ; Hemodynamics - drug effects ; Hemoglobin ; Humans ; Hypotension ; Hypotension - chemically induced ; Hypotension - drug therapy ; Intensive ; Internal Medicine ; Intraoperative Complications - chemically induced ; Intraoperative Complications - drug therapy ; Liver transplants ; Mastectomy ; Medicine ; Medicine & Public Health ; Middle Aged ; Monitoring, Intraoperative ; Neurology ; Original Article ; Oxygen Consumption - drug effects ; Oxygen saturation ; Parathyroidectomy ; Patients ; Phenylephrine - administration & dosage ; Phenylephrine - adverse effects ; Propofol ; Regional Blood Flow - drug effects ; Software ; Spectrum analysis ; Thyroidectomy ; Variance analysis ; Vasoconstrictor Agents - adverse effects ; Vasoconstrictor Agents - therapeutic use ; Ventilators</subject><ispartof>Neurocritical care, 2010-02, Vol.12 (1), p.17-23</ispartof><rights>Springer Science+Business Media, LLC 2009</rights><rights>Springer Science+Business Media, LLC 2009.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-ea49a511fe2014763a52fcabc4f285e94b01a4a0c8c1770d23e79a0301eed4c03</citedby><cites>FETCH-LOGICAL-c403t-ea49a511fe2014763a52fcabc4f285e94b01a4a0c8c1770d23e79a0301eed4c03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12028-009-9313-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2919332512?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,21369,21370,27905,27906,33511,33512,33725,33726,41469,42538,43640,43786,51300,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19957053$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nissen, Peter</creatorcontrib><creatorcontrib>Brassard, Patrice</creatorcontrib><creatorcontrib>Jørgensen, Thomas B.</creatorcontrib><creatorcontrib>Secher, Niels H.</creatorcontrib><title>Phenylephrine but not Ephedrine Reduces Frontal Lobe Oxygenation Following Anesthesia-Induced Hypotension</title><title>Neurocritical care</title><addtitle>Neurocrit Care</addtitle><addtitle>Neurocrit Care</addtitle><description>Background
Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (S
c
O
2
) following anesthesia-induced hypotension.
Methods
Following induction of anesthesia by fentanyl (0.15 mg kg
−1
) and propofol (2.0 mg kg
−1
), 13 patients received phenylephrine (0.1 mg iv) and 12 patients received ephedrine (10 mg iv) to restore mean arterial pressure (MAP). Heart rate (HR), MAP, stroke volume (SV), cardiac output (CO), and frontal lobe oxygenation (S
c
O
2
) were registered.
Results
Induction of anesthesia was followed by a decrease in MAP, HR, SV, and CO concomitant with an elevation in S
c
O
2
. After administration of phenylephrine, MAP increased (51 ± 12 to 81 ± 13 mmHg;
P
<
0.001; mean ± SD). However, a 14% (from 70 ± 8% to 60 ± 7%) reduction in S
c
O
2
(
P
<
0.05) followed with no change in CO (3.7 ± 1.1 to 3.4 ± 0.9 l min
−1
). The administration of ephedrine led to a similar increase in MAP (53 ± 9 to 79 ± 8 mmHg;
P
<
0.001), restored CO (3.2 ± 1.2 to 5.0 ± 1.3 l min
−1
), and preserved S
c
O
2
.
Conclusions
The utilization of phenylephrine to correct hypotension induced by anesthesia has a negative impact on S
c
O
2
while ephedrine maintains frontal lobe oxygenation potentially related to an increase in CO.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia, General</subject><subject>Blood</subject><subject>Critical Care Medicine</subject><subject>Ephedrine - administration & dosage</subject><subject>Ephedrine - adverse effects</subject><subject>Female</subject><subject>Fentanyl</subject><subject>Flow velocity</subject><subject>Frontal Lobe - blood supply</subject><subject>Frontal Lobe - drug effects</subject><subject>Hemodynamics</subject><subject>Hemodynamics - drug effects</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hypotension</subject><subject>Hypotension - chemically induced</subject><subject>Hypotension - drug therapy</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Intraoperative Complications - chemically induced</subject><subject>Intraoperative Complications - drug therapy</subject><subject>Liver transplants</subject><subject>Mastectomy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Monitoring, Intraoperative</subject><subject>Neurology</subject><subject>Original Article</subject><subject>Oxygen Consumption - drug effects</subject><subject>Oxygen saturation</subject><subject>Parathyroidectomy</subject><subject>Patients</subject><subject>Phenylephrine - administration & dosage</subject><subject>Phenylephrine - adverse effects</subject><subject>Propofol</subject><subject>Regional Blood Flow - drug effects</subject><subject>Software</subject><subject>Spectrum analysis</subject><subject>Thyroidectomy</subject><subject>Variance analysis</subject><subject>Vasoconstrictor Agents - adverse effects</subject><subject>Vasoconstrictor Agents - therapeutic use</subject><subject>Ventilators</subject><issn>1541-6933</issn><issn>1556-0961</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU2LFDEQhoMo7of-AC_S4MFTtPLVmRyXZcddGFgRPYd0unqml56kTbpx5t-b3hlYEDxVqDzvW0W9hHxg8IUB6K-ZceArCmCoEUzQwytyyZSqKZiavV7ektHaCHFBrnJ-AuDaaPWWXDBjlAYlLkn_fYfhOOC4S33AqpmnKsSpuht32D53fmA7e8zVOsUwuaHaxAarx8Nxi8FNfQzVOg5D_NOHbXUTME87zL2jD2FRtdX9cYwThlzAd-RN54aM78_1mvxa3_28vaebx28Ptzcb6iWIiaKTxinGOuTApK6FU7zzrvGy4yuFRjbAnHTgV55pDS0XqI0DAQyxlR7ENfl88h1T_D2Xjey-zx6HwQWMc7Za1nwlRM0L-ekf8inOKZTlLDesnI0rtlDsRPkUc07Y2TH1e5eOloFdYrCnGGyJwS4x2EPRfDw7z80e2xfF-e4F4Ccgl6-wxfQy-v-ufwETDpQd</recordid><startdate>20100201</startdate><enddate>20100201</enddate><creator>Nissen, Peter</creator><creator>Brassard, Patrice</creator><creator>Jørgensen, Thomas B.</creator><creator>Secher, Niels H.</creator><general>Humana Press Inc</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7TK</scope></search><sort><creationdate>20100201</creationdate><title>Phenylephrine but not Ephedrine Reduces Frontal Lobe Oxygenation Following Anesthesia-Induced Hypotension</title><author>Nissen, Peter ; Brassard, Patrice ; Jørgensen, Thomas B. ; Secher, Niels H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c403t-ea49a511fe2014763a52fcabc4f285e94b01a4a0c8c1770d23e79a0301eed4c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia, General</topic><topic>Blood</topic><topic>Critical Care Medicine</topic><topic>Ephedrine - administration & dosage</topic><topic>Ephedrine - adverse effects</topic><topic>Female</topic><topic>Fentanyl</topic><topic>Flow velocity</topic><topic>Frontal Lobe - blood supply</topic><topic>Frontal Lobe - drug effects</topic><topic>Hemodynamics</topic><topic>Hemodynamics - drug effects</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hypotension</topic><topic>Hypotension - chemically induced</topic><topic>Hypotension - drug therapy</topic><topic>Intensive</topic><topic>Internal Medicine</topic><topic>Intraoperative Complications - chemically induced</topic><topic>Intraoperative Complications - drug therapy</topic><topic>Liver transplants</topic><topic>Mastectomy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Monitoring, Intraoperative</topic><topic>Neurology</topic><topic>Original Article</topic><topic>Oxygen Consumption - drug effects</topic><topic>Oxygen saturation</topic><topic>Parathyroidectomy</topic><topic>Patients</topic><topic>Phenylephrine - administration & dosage</topic><topic>Phenylephrine - adverse effects</topic><topic>Propofol</topic><topic>Regional Blood Flow - drug effects</topic><topic>Software</topic><topic>Spectrum analysis</topic><topic>Thyroidectomy</topic><topic>Variance analysis</topic><topic>Vasoconstrictor Agents - adverse effects</topic><topic>Vasoconstrictor Agents - therapeutic use</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nissen, Peter</creatorcontrib><creatorcontrib>Brassard, Patrice</creatorcontrib><creatorcontrib>Jørgensen, Thomas B.</creatorcontrib><creatorcontrib>Secher, Niels H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Neurosciences Abstracts</collection><jtitle>Neurocritical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nissen, Peter</au><au>Brassard, Patrice</au><au>Jørgensen, Thomas B.</au><au>Secher, Niels H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Phenylephrine but not Ephedrine Reduces Frontal Lobe Oxygenation Following Anesthesia-Induced Hypotension</atitle><jtitle>Neurocritical care</jtitle><stitle>Neurocrit Care</stitle><addtitle>Neurocrit Care</addtitle><date>2010-02-01</date><risdate>2010</risdate><volume>12</volume><issue>1</issue><spage>17</spage><epage>23</epage><pages>17-23</pages><issn>1541-6933</issn><eissn>1556-0961</eissn><abstract>Background
Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (S
c
O
2
) following anesthesia-induced hypotension.
Methods
Following induction of anesthesia by fentanyl (0.15 mg kg
−1
) and propofol (2.0 mg kg
−1
), 13 patients received phenylephrine (0.1 mg iv) and 12 patients received ephedrine (10 mg iv) to restore mean arterial pressure (MAP). Heart rate (HR), MAP, stroke volume (SV), cardiac output (CO), and frontal lobe oxygenation (S
c
O
2
) were registered.
Results
Induction of anesthesia was followed by a decrease in MAP, HR, SV, and CO concomitant with an elevation in S
c
O
2
. After administration of phenylephrine, MAP increased (51 ± 12 to 81 ± 13 mmHg;
P
<
0.001; mean ± SD). However, a 14% (from 70 ± 8% to 60 ± 7%) reduction in S
c
O
2
(
P
<
0.05) followed with no change in CO (3.7 ± 1.1 to 3.4 ± 0.9 l min
−1
). The administration of ephedrine led to a similar increase in MAP (53 ± 9 to 79 ± 8 mmHg;
P
<
0.001), restored CO (3.2 ± 1.2 to 5.0 ± 1.3 l min
−1
), and preserved S
c
O
2
.
Conclusions
The utilization of phenylephrine to correct hypotension induced by anesthesia has a negative impact on S
c
O
2
while ephedrine maintains frontal lobe oxygenation potentially related to an increase in CO.</abstract><cop>New York</cop><pub>Humana Press Inc</pub><pmid>19957053</pmid><doi>10.1007/s12028-009-9313-x</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1541-6933 |
| ispartof | Neurocritical care, 2010-02, Vol.12 (1), p.17-23 |
| issn | 1541-6933 1556-0961 |
| language | eng |
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| source | MEDLINE; ProQuest Central (Alumni Edition); Springer Nature - Complete Springer Journals; ProQuest Central UK/Ireland; ProQuest Central |
| subjects | Adult Aged Anesthesia, General Blood Critical Care Medicine Ephedrine - administration & dosage Ephedrine - adverse effects Female Fentanyl Flow velocity Frontal Lobe - blood supply Frontal Lobe - drug effects Hemodynamics Hemodynamics - drug effects Hemoglobin Humans Hypotension Hypotension - chemically induced Hypotension - drug therapy Intensive Internal Medicine Intraoperative Complications - chemically induced Intraoperative Complications - drug therapy Liver transplants Mastectomy Medicine Medicine & Public Health Middle Aged Monitoring, Intraoperative Neurology Original Article Oxygen Consumption - drug effects Oxygen saturation Parathyroidectomy Patients Phenylephrine - administration & dosage Phenylephrine - adverse effects Propofol Regional Blood Flow - drug effects Software Spectrum analysis Thyroidectomy Variance analysis Vasoconstrictor Agents - adverse effects Vasoconstrictor Agents - therapeutic use Ventilators |
| title | Phenylephrine but not Ephedrine Reduces Frontal Lobe Oxygenation Following Anesthesia-Induced Hypotension |
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