Remifentanil and nitrous oxide reduce changes in cerebral blood flow velocity in the middle cerebral artery caused by pain |
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| Authors: | Lorenz I H Kolbitsch C Hinteregger M Bauer P Spiegel M Luger T J Schmidauer C Streif W Pfeiffer K P Benzer A |
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| Institution: | 1 Department of Anaesthesia and Intensive Care Medicine, 2 Department of Neurology, 3 Department of Paediatrics, 4 Department of Biostatistics and Documentation, University of Innsbruck, A-6020 Innsbruck, Anichstrasse 35, Austria |
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| Abstract: | Background. Cerebral blood flow is affected by painful stimuli,and analgesic agents may alter the response of cerebral bloodflow to pain. We set out to quantify the effects of remifentaniland nitrous oxide on blood flow changes caused by experimentalpain. Methods. We simulated surgical pain in 10 conscious volunteersusing increasing mechanical pressure to the tibia. We measuredchanges in cerebral blood flow velocity in the middle cerebralartery (CBFVMCA) caused by the pain, using transcranial Dopplersonography. We gave increasing doses of remifentanil (0.025,0.05 and 0.1 µg kg–1 min–1)or nitrous oxide 20%, 35% and 50% end-tidal concentration (FE'N2O)]and compared these effects on blood flow changes. Results. Nitrous oxide increased CBFVMCA only when given at50% FE'N2O. Remifentanil did not affect CBFVMCA. Pain increasedCBFVMCA. Both agents attenuated this pain-induced change inCBFVMCA with the exception of nitrous oxide at 20% FE'N2O. Conclusions. Inhalation of nitrous oxide or adminstration ofremifentanil attenuated pain-induced changes in CBFVMCA. Br J Anaesth 2003: 90: 296–9 |
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| Keywords: | anaesthetics gases nitrous oxide analgesics opioid remifentanil brain blood flow pain |
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