Blood flow and oxygen uptake of the cerebral cortex of the dog during anaesthesia with different volatile agents

Cerebral blood flow responses to hypocapnia during hypotension

Cerebral vascular responses to hypocapnia during hypotension to a mean arterial blood pressure (MAP) = 50 mm Hg induced with sodium nitroprusside (SNP, n = 12) or trimethaphan (TMP, n = 12) were examined in dogs. Cerebral vascular resistance (CVR) and cerebral blood flow (CBF) at PaCO2 = 40 mm Hg, and PaCO2 = 20 mm Hg were examined first at normal MAP then at hypotension in six dogs in the SNP group and six dogs in the TMP group. In both the SNP group and the TMP group, CO2 responsiveness, as indicated by increased CVR and decreased CBF, was intact at normal MAP, but absent during hypotension. In the remaining 6 of 12 dogs in the SNP group and 6 of 12 dogs in the TMP group, CO2 responsiveness at MAP = 50 mm Hg was examined without prior determination of CO2 responsiveness at normal MAP. These additional studies were performed to rule out the possibility that absent CO2 responsiveness during hypotension in the initial groups resulted from (1) physiologic deterioration of the preparation with time, or (2) adaptation of brain extracellular fluid pH to a preceding period of hypocapnia. Again, during both SNP- or TMP-induced hypotension CO2 responsiveness was absent.

Failure of intravascular volume expansion without hemodilution to elevate cortical blood flow in region of experimental focal ischemia

Cerebrovascular and cardiac alterations evoked by intravascular volume expansion with whole blood, a popular adjunct in the clinical prevention or therapy of the focal ischemic deficits of cerebral vasospasm and acute stroke, were studied in splenectomized dogs. Clipping of the right distal internal carotid and proximal middle cerebral arteries in eight dogs reduced regional cortical blood flow (rCoBF) by 49% to 58% without altering cardiac output (CO), and produced about 10% hemispheric infarction. Eight dogs underwent similar cerebral arterial occlusion and eight dogs underwent arterial manipulation without clipping. Both latter groups received two autologous whole blood infusions within 2 hours, each equal to 20% of the respective dog's total blood volume. Despite significant CO elevations after the infusions, rCoBF in the middle cerebral arterial territory did not rise. These whole-blood infusions did not significantly alter mean arterial blood pressure, hematocrit, intracranial pressure, or, in dogs with clipped cerebral arteries, the relative size of infarction. These data suggest that nondilutional hypervolemia neither elevates collateral perfusion to ischemic regions of the brain nor reduces infarction. In addition, elevations in CO do not appear to augment blood flow in either ischemic or normal brain.

Hemodynamic and clinicopathologic verification of a stroke model in the dog

Twenty-five mongrel dogs had intracranial internal carotid and proximal middle cerebral artery occlusions. The animals were followed for one week and subsequently sacrificed. This method of clipping produced a mean drop in cortical cerebral blood flow of 48.4% as measured by the 85Kr washout technique. Cerebral blood flow was not affected by the brain retraction necessary for clip placements. Mortality in the first week was 16% and neurological deficits were observed in 73% of the animals. Infarction was present in 80% of the animals, and the mean percent infarction of the affected hemisphere was 17.00 +/0 3.98SE. This is a useful stroke model in an animal which is easily available, inexpensive, and suitable for microvascular intracranial surgery research.

Cerebrovascular effects of central depressants: a study of nitrous oxide, halothane, pentobarbital and ethanol during normocapnia and hypercapnia in the rat

The effect of the central depressants nitrous oxide, halothane, pentobarbital and ethanol upon cerebral blood flow (CBF), cerebral oxygen consumption (CMRO2) and cerebral vascular reactivity to carbon dioxide were measured using the rapid and repetitive intraarterial 133Xenon injection technique modified for rat studies. The cerebrovascular resistance (CVR) during normocapnia in the pentobarbital group was significantly higher (P less than 0.01) than in the nitrous oxide group thus indicating a vasoconstrictor effect of pentobarbital that may be clinically important, because the ability of barbiturates to contract vessels in healthy brain regions may partly explain the protective properties of these drugs against cerebral ischemia. The results indicated that pentobarbital and ethanol may act synergistically with carbon dioxide in depressing CMRO2 and cerebral vascular reactivity. Finally, it is concluded that nitrous oxide anaesthesia (70% N2O: 30% O2) is suitable as a reference situation in rat studies of the effect of pharmocological agents on CBF, CMRO2 and cerebrovascular reactivity.

Control of cerebral vascular smooth muscle during general anaesthesia

The effects of some general anaesthetics, for example thiopentone, Althesin (alphaxalone + alphadolone) and ketamine, on cerebral vascular smooth muscle are those which would be expected from their metabolic actions. With other anaesthetics, mainly those administered by inhalation, and especially the volatile agents, cerebral blood flow increases in excess of the metabolic activity, which is usually depressed to varying degrees. During general anaesthesia with any of these agents, responses to changes in arterial Pco2 or blood pressure are maintained. Furthermore, when seizure activity occurs during enflurane administration, there is a flow response to the associated metabolic stimulation. The time course of the flow response to the metabolically depressant drug Althesin has been measured in baboons and shown to be very rapid. Wtih this drug cerebrovascular resistance begins to increase within 2 s of its arrival in the brain. This rapid flow change occurs also after sympathetic denervation. Extracellular fluid pH of the cortex does not alter until after the initiation of the vascular smooth muscle response.

The responses of cortical neurones to monoamines under differing anaesthetic conditions

1. Noradrenaline, isoprenaline, 5-hydroxytryptamine and acetylcholine have been applied into the environment of single neurones in the cat cerebral cortex by micro-iontophoresis. The influence of anaesthesia on the neuronal responses to these drugs was studied.2. In general, excitation of neurones by noradrenaline occurred commonly in both unanaesthetized encéphale isolé (48%) and N(2)O-halothane anaesthetized preparations (57%) while depressions were less frequent (24 and 20% respectively). The picture differed markedly in barbiturate anaesthetized animals where excitation was uncommon (12%) and the majority of cells (59%) was depressed by noradrenaline. Although fewer cells were studied, similar differences were obtained with isoprenaline and 5-hydroxytryptamine for the three types of preparation. In sharp contrast, the vast majority of cells was excited by acetylcholine in each of the preparations: encéphale isolé 84%; N(2)O-halothane 92%; barbiturate anaesthetized preparations 85%.3. The differing neuronal responses observed in these experimental situations were not the result of variations in the depth of anaesthesia.4. Although the depths at which neurones were encountered within the cortex did not differ in N(2)O-halothane and encéphale isolé preparations, significantly more cells were found in deeper layers of cortex in barbiturate preparations. The proportion of cells excited or depressed by noradrenaline was generally similar at each depth in the three preparations used.5. The distribution of rates of cell firing was strikingly similar in each preparation, and most of the cells studied had frequencies below 10/sec.6. The direction in which a cell responds to noradrenaline is mainly determined by the type of anaesthetic used, and not by the depth of anaesthesia, the rate of cell firing, or cell depth within the cortex. This suggests important differences in the central pharmacology of halothane and barbiturates.