09 January 2002
The influence of controlled hypotension on splanchnic mucosal perfusion using gastric tonometry in patients undergoing resection of meningioma.
Rafal Nowicki, Piotr Kowalczyk, Cezary Pakulski, Piotr Bak, Krzysztof Mikulski, Beata BadowiczMed Sci Monit 2002; 8(1): CR28-30 :: ID: 420967
Abstract
BACKGROUND: The aim of our research was to evaluate the influence of generalanesthesia with controlled nitroglycerin-induced hypotension on splanchnic mucosal perfusion using gastrictonometry. MATERIAL/METHODS: In six patients (1 female, 5 males, median age 46 years, range 32-62) undergoingelective resection of meningiomas, measurements of gastric mucosal perfusion were taken by nasogastrictonometry. Controlled hypotension was initiated after craniotomy and terminated prior to hemostasis procedures.The mean arterial blood pressure (MAP) was maintained 25-30% below initial parameters during controlledhypotension. The adequacy of perfusion was defined by the intramucosal pH (pHi) and the difference betweenarterial and intramucosal pH (pHGAP). All parameters were analyzed before the induction of controlledhypotension, after the 1st, 2nd, and 3rd hour, and 1 hour after the termination of controlled hypotension.RESULTS: The MAP decreased during controlled hypotension by ca. 26.5% (min. 21.1%; max 31.6%). The lowerMAP was accompanied by a statistically significant increase in heart rate. A significant increase frombaseline in regional prCO2 was seen after the 1st, 2nd, and 3rd hour of controlled hypotension. IntramucosalpH values decreased significantly during the same period, from 7.428+/-0.032 to 7.372+/-0.015. Despitethese statistically significant differences during controlled hypotension, the pHi values were alwaysgreater than 7.35, and the pHGAP values were lower than 0.05, which were recognized as being within thenormal range. CONCLUSIONS: Controlled hypotension allows accurate evaluation of the blood flow qualityat the level of microcirculation. Mild controlled hypotension slightly alters splanchnic mucosal perfusion,but does not lead to ischemia and hypoxia in tissues.
Keywords: Anesthetics, Anoxia, Blood Pressure, Hydrogen-Ion Concentration, Hypotension, Ischemia, Oxygen, Perfusion, Splanchnic Circulation, Stomach, Tonometry, Ocular
Editorial
01 March 2024 : Editorial
Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and Transfusion-Dependent β-ThalassemiaDOI: 10.12659/MSM.944204
Med Sci Monit 2024; 30:e944204
In Press
21 Feb 2024 : Clinical Research
Potential Value of HSP90α in Prognosis of Triple-Negative Breast CancerMed Sci Monit In Press; DOI: 10.12659/MSM.943049
22 Feb 2024 : Review article
Differentiation of Native Vertebral Osteomyelitis: A Comprehensive Review of Imaging Techniques and Future ...Med Sci Monit In Press; DOI: 10.12659/MSM.943168
23 Feb 2024 : Clinical Research
A Study of 60 Patients with Low Back Pain to Compare Outcomes Following Magnetotherapy, Ultrasound, Laser, ...Med Sci Monit In Press; DOI: 10.12659/MSM.943732
26 Feb 2024 : Clinical Research
Predictive Value of Combined HbA1c and Neutrophil-to-Lymphocyte Ratio for Diabetic Peripheral Neuropathy in...Med Sci Monit In Press; DOI: 10.12659/MSM.942509
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952