Differences in PCO2, pH, Lactate, K + and Na+ Between Arterial Blood and Jugular Bulb Blood in Patients Subjected to Craniotomy in Either Propofol-Fentanyl or Propofol-Remifentanil Anaesthesia
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Studies of intensive care patients indicate that the arteriovenous difference (AVD) of PCO2 in the systemic circulation increases during critical hypoperfusion. As regards the cerebral circulation, studies in pigs indicate that the AVD-PCO2 increases with CBF reduction. In patients subjected to craniotomy for supratentorial cerebral tumours the AVD-PCO2 or AVD-pH has not been studied. It has repeatedly been documented that low values of jugular bulb oxygen saturation (SjO2) and high values of AVDO2 occur during anaesthesia with propofol-fentanyl or propofol-alfentanil, and in a comparative study of propofol-fentanyl or propofol-remifentanil anaesthesia SjO2 is even lower during the latter. In this chapter, the results of a database study of AVD of physiological parameters are reported and discussed. We investigated the relationships between AVDO2, AVD-PCO2, AVD-pH, AVD of the electrolytes Na+, K+ and Ca++, SjO2, jugular oxygen content and jugular oxygen tension during maintenance anaesthesia with propofol-fentanyl and propofol-remifentanil.
KeywordsCerebral Ischaemia Global Cerebral Ischaemia Jugular Bulb Maintenance Anaesthesia Equal Variance Test
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