The effect of dexmedetomidine on cerebral perfusion and oxygenation in healthy piglets with normal and lowered blood pressure anaesthetized with propofol-remifentanil total intravenous anaesthesia
Abstract Background During anaesthesia and surgery, in particular neurosurgery, preservation of cerebral perfusion and oxygenation (CPO) is essential for normal postoperative brain function. The isolated effects on CPO of either individual anaesthetic drugs or entire anaesthetic protocols are of imp...
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| Format: | Article |
| Language: | English |
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BMC
2017-05-01
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| Series: | Acta Veterinaria Scandinavica |
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| Online Access: | http://link.springer.com/article/10.1186/s13028-017-0293-0 |
| _version_ | 1819002721401831424 |
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| author | Mai Louise Grandsgaard Mikkelsen Rikard Ambrus Rune Rasmussen James Edward Miles Helle Harding Poulsen Finn Borgbjerg Moltke Thomas Eriksen |
| author_facet | Mai Louise Grandsgaard Mikkelsen Rikard Ambrus Rune Rasmussen James Edward Miles Helle Harding Poulsen Finn Borgbjerg Moltke Thomas Eriksen |
| author_sort | Mai Louise Grandsgaard Mikkelsen |
| collection | DOAJ |
| description | Abstract Background During anaesthesia and surgery, in particular neurosurgery, preservation of cerebral perfusion and oxygenation (CPO) is essential for normal postoperative brain function. The isolated effects on CPO of either individual anaesthetic drugs or entire anaesthetic protocols are of importance in both clinical and research settings. Total intravenous anaesthesia (TIVA) with propofol and remifentanil is widely used in human neuroanaesthesia. In addition, dexmedetomidine is receiving increasing attention as an anaesthetic adjuvant in neurosurgical, intensive care, and paediatric patients. Despite the extensive use of pigs as animal models in neuroscience and the increasing use of both propofol-remifentanil and dexmedetomidine, very little is known about their combined effect on CPO in pigs with uninjured brains. This study investigates the effect of dexmedetomidine on CPO in piglets with normal and lowered blood pressure during background anaesthesia with propofol-remifentanil TIVA. Sixteen healthy female Danish pigs (crossbreeds of Danish Landrace, Yorkshire and Duroc, 25–34 kg) were used. Three animals were subsequently excluded. The animals were randomly allocated into one of two groups with either normal blood pressure (NBP, n = 6) or with induced low blood pressure (LBP, n = 7). Both groups were subjected to the same experimental protocol. Intravenous propofol induction was performed without premedication. Anaesthesia was maintained with propofol-remifentanil TIVA, and later supplemented with continuous infusion of dexmedetomidine. Assessments of cerebral perfusion obtained by laser speckle contrast imaging (LSCI) were related to cerebral oxygenation measures (PbrO2) obtained by an intracerebral Clark-type Licox probe. Results Addition of dexmedetomidine resulted in a 32% reduction in median PbrO2 values for the LBP group (P = 0.03), but no significant changes in PbrO2 were observed for the NBP group. No significant changes in LSCI readings were observed in either group between any time points, despite a 28% decrease in the LBP group following dexmedetomidine administration. Caval block resulted in a significant (P = 0.02) reduction in median MAP from 68 mmHg (range 63–85) at PCB to 58 mmHg (range 53–63) in the LBP group, but no significant differences in either PbrO2 or LSCI were observed due to this intervention (P = 0.6 and P = 0.3 respectively). Conclusions Addition of dexmedetomidine to propofol-remifentanil TIVA resulted in a significant decrease in cerebral oxygenation (PbrO2) measurements in piglets with lowered blood pressure. Cerebral perfusion (LSCI) did not decrease significantly in this group. In piglets with normal blood pressure, no significant changes in cerebral perfusion or oxygenation were seen in response to addition of dexmedetomidine to the background anaesthesia. |
| first_indexed | 2024-12-20T23:09:36Z |
| format | Article |
| id | doaj.art-fdad2b75fb5c45dda104b6b9989f659a |
| institution | Directory Open Access Journal |
| issn | 1751-0147 |
| language | English |
| last_indexed | 2024-12-20T23:09:36Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Acta Veterinaria Scandinavica |
| spelling | doaj.art-fdad2b75fb5c45dda104b6b9989f659a2022-12-21T19:23:46ZengBMCActa Veterinaria Scandinavica1751-01472017-05-0159111310.1186/s13028-017-0293-0The effect of dexmedetomidine on cerebral perfusion and oxygenation in healthy piglets with normal and lowered blood pressure anaesthetized with propofol-remifentanil total intravenous anaesthesiaMai Louise Grandsgaard Mikkelsen0Rikard Ambrus1Rune Rasmussen2James Edward Miles3Helle Harding Poulsen4Finn Borgbjerg Moltke5Thomas Eriksen6Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of CopenhagenDepartment of Surgical Gastroenterology C, Rigshospitalet, Faculty of Health and Medical Sciences, University of CopenhagenDepartment of Neurosurgery, The Neuroscience Centre, Rigshospitalet, Faculty of Health and Medical Sciences, University of CopenhagenDepartment of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of CopenhagenDepartment of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of CopenhagenDepartment of Neuroanaesthesia, Rigshospitalet, University of CopenhagenDepartment of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of CopenhagenAbstract Background During anaesthesia and surgery, in particular neurosurgery, preservation of cerebral perfusion and oxygenation (CPO) is essential for normal postoperative brain function. The isolated effects on CPO of either individual anaesthetic drugs or entire anaesthetic protocols are of importance in both clinical and research settings. Total intravenous anaesthesia (TIVA) with propofol and remifentanil is widely used in human neuroanaesthesia. In addition, dexmedetomidine is receiving increasing attention as an anaesthetic adjuvant in neurosurgical, intensive care, and paediatric patients. Despite the extensive use of pigs as animal models in neuroscience and the increasing use of both propofol-remifentanil and dexmedetomidine, very little is known about their combined effect on CPO in pigs with uninjured brains. This study investigates the effect of dexmedetomidine on CPO in piglets with normal and lowered blood pressure during background anaesthesia with propofol-remifentanil TIVA. Sixteen healthy female Danish pigs (crossbreeds of Danish Landrace, Yorkshire and Duroc, 25–34 kg) were used. Three animals were subsequently excluded. The animals were randomly allocated into one of two groups with either normal blood pressure (NBP, n = 6) or with induced low blood pressure (LBP, n = 7). Both groups were subjected to the same experimental protocol. Intravenous propofol induction was performed without premedication. Anaesthesia was maintained with propofol-remifentanil TIVA, and later supplemented with continuous infusion of dexmedetomidine. Assessments of cerebral perfusion obtained by laser speckle contrast imaging (LSCI) were related to cerebral oxygenation measures (PbrO2) obtained by an intracerebral Clark-type Licox probe. Results Addition of dexmedetomidine resulted in a 32% reduction in median PbrO2 values for the LBP group (P = 0.03), but no significant changes in PbrO2 were observed for the NBP group. No significant changes in LSCI readings were observed in either group between any time points, despite a 28% decrease in the LBP group following dexmedetomidine administration. Caval block resulted in a significant (P = 0.02) reduction in median MAP from 68 mmHg (range 63–85) at PCB to 58 mmHg (range 53–63) in the LBP group, but no significant differences in either PbrO2 or LSCI were observed due to this intervention (P = 0.6 and P = 0.3 respectively). Conclusions Addition of dexmedetomidine to propofol-remifentanil TIVA resulted in a significant decrease in cerebral oxygenation (PbrO2) measurements in piglets with lowered blood pressure. Cerebral perfusion (LSCI) did not decrease significantly in this group. In piglets with normal blood pressure, no significant changes in cerebral perfusion or oxygenation were seen in response to addition of dexmedetomidine to the background anaesthesia.http://link.springer.com/article/10.1186/s13028-017-0293-0Cerebral perfusionCerebral oxygenationSwinePropofolRemifentanilDexmedetomidine |
| spellingShingle | Mai Louise Grandsgaard Mikkelsen Rikard Ambrus Rune Rasmussen James Edward Miles Helle Harding Poulsen Finn Borgbjerg Moltke Thomas Eriksen The effect of dexmedetomidine on cerebral perfusion and oxygenation in healthy piglets with normal and lowered blood pressure anaesthetized with propofol-remifentanil total intravenous anaesthesia Acta Veterinaria Scandinavica Cerebral perfusion Cerebral oxygenation Swine Propofol Remifentanil Dexmedetomidine |
| title | The effect of dexmedetomidine on cerebral perfusion and oxygenation in healthy piglets with normal and lowered blood pressure anaesthetized with propofol-remifentanil total intravenous anaesthesia |
| title_full | The effect of dexmedetomidine on cerebral perfusion and oxygenation in healthy piglets with normal and lowered blood pressure anaesthetized with propofol-remifentanil total intravenous anaesthesia |
| title_fullStr | The effect of dexmedetomidine on cerebral perfusion and oxygenation in healthy piglets with normal and lowered blood pressure anaesthetized with propofol-remifentanil total intravenous anaesthesia |
| title_full_unstemmed | The effect of dexmedetomidine on cerebral perfusion and oxygenation in healthy piglets with normal and lowered blood pressure anaesthetized with propofol-remifentanil total intravenous anaesthesia |
| title_short | The effect of dexmedetomidine on cerebral perfusion and oxygenation in healthy piglets with normal and lowered blood pressure anaesthetized with propofol-remifentanil total intravenous anaesthesia |
| title_sort | effect of dexmedetomidine on cerebral perfusion and oxygenation in healthy piglets with normal and lowered blood pressure anaesthetized with propofol remifentanil total intravenous anaesthesia |
| topic | Cerebral perfusion Cerebral oxygenation Swine Propofol Remifentanil Dexmedetomidine |
| url | http://link.springer.com/article/10.1186/s13028-017-0293-0 |
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