Canadian Journal of Anaesthesia

, Volume 44, Issue 2, pp 160–164 | Cite as

Cerebrovascular CO2 reactivity in elderly and younger adult patients during sevoflurane anaesthesia

  • Tomoki Nishiyama
  • Naosuke Sugai
  • Kazuo Hanaoka
Reports of Investigation



General anaesthetic agents and aging affect cerebrovascular CO2 reactivity (CCO2R). The purpose of this study was to investigate the effect of aging on CCO2R in patients during sevoflurane anaesthesia.


Twenty-four patients were divided into two groups of 12 according to age; 20–40 yr and 50–70 yr. Anaesthesia was induced with 5 mg · kg−1 thiopentone and maintained with sevoflurane 1.0 to 1.5% (end-tidal) and nitrous oxide 66% in oxygen to maintain anaesthesia. End-tidal CO2 tension (PetCO2) was altered from 20 to 50 mmHg in 5 mmHg steps by changing the respiratory rate. Middle cerebral blood flow velocity (CBFV) and pulsatility index (Pl) were measured by transcranial Doppier (TCD) at each step change in PetCO2. The CCO2R was calculated as the change of CBFV per mmHg at each 5 mmHg interval.


In each group, there were no changes in blood pressure, heart rate, end-tidal sevoflurane concentration, or Pl as the PETCO2 was increased from 20 to 50 mmHg. The CCO2R at PETCO2 of 35 to 50 mmHg in the younger group (0.80 ± 0.27 (SD) cm·sec−1·mrnHg−1) was larger than that in the elderly group (0.31 ± 0.16 cm · sec−1 mmHg−1)(P< 0.0l).


It is concluded that, during sevoflurane anaesthesia. CCO2R is well preserved, and that the CCO2R at PETCO2 of 35 to 50 mmHg in the 20 to 40 yr age group is greater than that in the 50 to 70 yr age group.


Sevoflurane Thiopentone Elderly Group Desflurane Pulsatility Index 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



L’anesthésie générale et le vieillissement affectent la réactivité cérébrovasculaire au CO2 (CCO2R). Ce travail visait à étudier l’effet du vieillissement sur la CCO2R pendant l’anesthésie au sévoflurane.


Vingt-quatre patients étaient répartis en deux groupes de 12 selon leur âge: 20 à 40 ans et 50 à 70 ans. L’anesthésie était induite avec du thiopentone 5 mg · kg−1 et maintenue avec du sévoflurane 1.0 à 1.5% (téléexpiratore) et du protoxyde d’azote 66% en oxygène. La PetCO2 était modifiée de 20 à 50 mmHg par échelons de 5 mmHg en changeant la fréquence respiratoire. La vélocité du débit sanguin cérébral (CBFV) et l’index de pulsatilrté (Pl) étaient mesurés à l’aide d’un Doppler transcrânien à chaque changement d’échelon de la PetCO2. La CCO2R était calculée comme le changement du CBFV par mmHg à chaque intervalle de 5 mmHg.


Dans chacun des groupes, la pression artérielle, la fréquence cardiaque, la concentration télé-expiratoire en sévoflurane n’ont pas changé, ainsi que le Pl lorsque la PetCO2 augmentait de 20 à 50 mmHg. Dans le groupe le plus jeune, aux PetCO2 de 35 à 50 mmHg, la CCO2R était plus élevée (0.80 ± 0,27 (ET) cm · s−1mmHg) que dans le groupe plus âgé (0.31 ± 0,16 cm·s−1mmHg, P < 0.0l).


Pendant l’anesthésie au sévoflurane, la CCO2R est bien préservée et aux PETCO2 de 35 à 50 mmHg. la CCO2R est plus élevée dans le groupe d’âge de 20 à 40 ans que dans celui de 50 à 70 ans.


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Copyright information

© Canadian Anesthesiologists 1997

Authors and Affiliations

  • Tomoki Nishiyama
    • 1
  • Naosuke Sugai
    • 1
  • Kazuo Hanaoka
    • 1
  1. 1.Department of Anacsthesiology, Faculty of MedicineThe University of TokyoTokyoJapan

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