Difference of Jugular Bulb Oxygen Saturation under Propofol, Enflurane and Isoflurane Anesthesia with Hydralazine-induced Deliberate Hypotension.

Lee,  Youn Suk; In,  Jun Yong; Choe,  Won Joo; Lee,  Jeong Han; Kim,  Kye Min; Yon,  Jun Heum; Kim,  Jung Won; Hong,  Ki Hyuk

doi:2002.42.4.487

Clinical Research Article

Korean Journal of Anesthesiology 2002;42(4):487-492.
DOI: https://doi.org/10.4097/kjae.2002.42.4.487

Difference of Jugular Bulb Oxygen Saturation under Propofol, Enflurane and Isoflurane Anesthesia with Hydralazine-induced Deliberate Hypotension.

Youn Suk Lee, Jun Yong In, Won Joo Choe, Jeong Han Lee, Kye Min Kim, Jun Heum Yon, Jung Won Kim, Ki Hyuk Hong

¹Department of Anesthesiology, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea.
²Department of Anesthesiology, Ilsan Paik Hospital, College of Medicine, Inje University, Koyang, Korea.

Abstract

BACKGROUND
Hydralazine produces cerebral vasodilation, which could appear differently according to which kind of anesthetics was used. SjO2, CBF and AJDO2 have been studied during general anesthesia with enflurane, isoflurane or propofol in 42 patients undergoing spinal surgery.
METHODS
Forty-two healthy adult patients were divided into Group P (Propofol-N2O, n = 15), Group E (Enflurane-N2O, n = 15) and Group I (Isoflurane-N2O, n = 12). During the course of the study, the anesthetic concentration was constant. Induced hypotension was provided with hydralazine 20 mg in combination with a continuous infusion of esmolol within 50 - 100ng/kg/min. Arterial blood and jugular bulb blood were obtained and analyzed at normotensive and hypotensive period, respectively. SjO2, was compared within and between groups.
RESULTS
SjO2 values of Group P were 66.2 +/- 7.7%, and 81.5 +/- 6.1%, those of Group E were 79.5 +/- 5.6%, and 78.9 +/- 4.9% and those of Group I were 82.0 +/- 6.2%, and 84.4 +/- 3.7% at normotension and hypotension, respectively (P < 0.05 between Group P and Group E, P < 0.05 between Group P and Group I, P < 0.05 within Group P).
CONCLUSIONS
When the changes of CBF is assumed with that of SjO2, it may be concluded that CBF increased with hydralazine-induced hypotension in propofol-N2O anesthesia. It may be suggested that hydralazine reverses propofol induced cerebral vasoconstriction.

Key Words: Enflurane; hydralazine; induced hypotension; isoflurane; jugular bulb oxygen saturation; propofol