DYNAMICS OF INTRACEREBRAL AND CEREBRAL PERFUSION PRESSURE DURING MAJOR
ABDOMINAL SURGERY
Zabolotskih I.B., Trembach N.V., Gormakova E.V.
Kuban State Medical University, Russia
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 fen tanyl and total intravenous anaesthesia with
propofol and fentanyl were used during the operations. Subgroups were identi fied in the groups of patients
depended on the basic intracerebral pressure (ICP); subgroup of patients with normal ICP (.12 mmHg) and
subgroup of patients with intracerebral hypertension (ICP>12 mmHg) Results; Intracerebral pressure
increased by 56% and cerebral perfusion pressure decreased by35% in patients with intracerebral
hypertension during the application of combined anaesthesia with sevoflurane. ICP decreased to normal
parameters during application of total intravenous anaes thesia 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 anaes thesia 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 propofolis a technique of choice in patients
with underling intracerebral hypertension.
Key words: intracerebral pressure, cerebral perfusion pressure, intracerebral hypertension, anaesthesia,
abdominal surgery
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