[Dynamics of intracerebral and cerebral perfusion pressure during major abdominal surgery]

Abstract

Purpose of the study was to compare an influence of anaesthesia with sevoflurane and propofol on intracerebral and cerebral perfusion pressure by data of ophthalmo-dynamometry of the central retinal vein.

Materials and methods: The article deals with study of 75 patients which were undergoing major abdominal surgery. Combined anaesthesia with sevoflurane and fentanyl and total intravenous anaesthesia with propofol and fentanyl were used during the operations. Subgroups were identified in the groups of patients depended on the basic intracerebral pressure (ICP); subgroup of patients with normal ICP (< or = 12 mmHg) and subgroup of patients with intracerebral hypertension (ICP > 12 mmHg)

Results: Intracerebral pressure increased by 56% and cerebral perfusion pressure decreased by 35% in patients with intracerebral hypertension during the application of combined anaesthesia with sevoflurane. ICP decreased to normal parameters during application of total intravenous anaesthesia with propofol in patients with intracerebral hypertension. There was no changes of intracerebral and cerepral perfusion pressure (CPP) in patients without cerebral hypertension. Awaking time in patients with intracerebral hypertension was longer by 1.6 times after anaesthesia with sevoflurane than after anaesthesia with propofol.

Conclusion: Combined inhalation anaesthesia with sevoflurane causes the increasing of ICP and decreasing of CPP and increasing of awaking time. Total intravenous anaesthesia with propofol and fentanyl provides stable cerebral haemodynamics. Total intravenous anaesthesia with propofol is a technique of choice in patients with underling intracerebral hypertension.