Subject(s)
Brain/diagnostic imaging , Hypnotics and Sedatives/administration & dosage , Tomography, X-Ray Computed , Child, Preschool , Contrast Media , Diazepam/administration & dosage , Drug Therapy, Combination , Humans , Infant , Injections, Intravenous , Pentobarbital/administration & dosage , Suppositories , Trimeprazine/administration & dosageSubject(s)
Brain Injuries/therapy , Cerebrovascular Circulation , Cerebrovascular Disorders/therapy , Positive-Pressure Respiration , Adolescent , Adult , Aged , Humans , Male , Middle AgedSubject(s)
Aortography , Iodobenzoates , Iothalamic Acid/analogs & derivatives , Triiodobenzoic Acids , Adult , Aged , Anesthesia, General , Aorta, Thoracic/diagnostic imaging , Blood Pressure/drug effects , Drug Evaluation , Female , Heart Rate/drug effects , Humans , Iothalamic Acid/adverse effects , Ioxaglic Acid , Male , Middle Aged , Triiodobenzoic Acids/adverse effectsABSTRACT
The effects of etomidate on regional cerebral blood flow (rc.b.f.) and cerebral metabolic rate for oxygen (CMRo2) were studied in seven patients undergoing diagnostic carotid angiography. Following determination of baseline rc.b.f. while awake, the patients were anaesthetized with a single dose of etomidate 15 mg. Thereafter, an infusion of etomidate (2 or 3 mg min-1) was administered. Etomidate decreased both rc.b.f.10 (mean decrease 34%) and CMRo2 (mean decrease 45%). It was concluded that etomidate is a potent cerebral metabolic depressant. Furthermore, the cerebrovascular reactivity to carbon dioxide was maintained under etomidate anaesthesia.
Subject(s)
Brain/metabolism , Cerebrovascular Circulation/drug effects , Etomidate/pharmacology , Imidazoles/pharmacology , Adult , Anesthesia, General , Female , Humans , Male , Oxygen Consumption/drug effectsSubject(s)
Brain/blood supply , Xenon Radioisotopes , Angiography , France , Humans , Radiology Department, Hospital , Regional Blood FlowABSTRACT
Recordings were electroencephalographical (EEG with spectral analysis), polygraphical (EMG, EKG, breathing). Visual and Auditory Cerebral Evoked Responses were also recorded. The depth of narcosis was quantified upon EEG data. The reactivity during the narcosis and the mechanisms of action of Etomidate on the "non specific structures" are discussed. Cautions should be taken with the use of tomidate in anesthesiology with epileptic and arteriopathic patients.
Subject(s)
Anesthesia, General , Brain/drug effects , Etomidate , Imidazoles , Muscles/drug effects , Adult , Aged , Alpha Rhythm , Cerebral Angiography , Clinical Trials as Topic , Drug Evaluation , Drug Tolerance , Electroencephalography , Electromyography , Etomidate/pharmacology , Evoked Potentials/drug effects , Female , Humans , Imidazoles/pharmacology , Male , Middle AgedABSTRACT
The effects of Etomidate on cerebral blood flow (C.B.F.) and cerebral oxygen consumption (C.02 C.) were studied in 13 patients in a neuroradiology department. Induction of anaesthesia was ensured using a standard dose of 15 mg of Etomidate, followed by a constant rate infusion (2.8 mg/kg/hour). Seven subjects were considered to be normal whilst six were suffering from tumour pathology. Under the influence of Etomidate, C.B.F. in the normal subjects decreased by 34 p. 100 and C.02 C. by 46.7 p. 100. The relationship between C.B.F. and arterial PC01 was studied under the influence of Etomidate: cerebral vasoactivity to C02 was maintained. A special study was made of focal changes in flow in patients with tumour pathology. Under the influence of Etomidate, there were zones of adaptation of flow, indicative of vasoparalysis situated opposite the tumour.
Subject(s)
Cerebrovascular Circulation/drug effects , Etomidate/pharmacology , Imidazoles/pharmacology , Oxygen Consumption/drug effects , Anesthesia, General , Brain/metabolism , Carbon Dioxide/blood , Cerebral Angiography , Clinical Trials as Topic , Humans , Oxygen/bloodABSTRACT
The effects of large doses of morphinomimetics on the cerebral circulation were studied in 12 normal subjects (fentanyl 16 microgram/kg in 6 patients and fentathienyl 1.9 microgram/kg in 6 others). Mean hemispheric flow (corrected to a pCO2 of 40) changed from 50.8 +/- 4.4 ml/100 g/min in the conscious state to 50.3 +/- 25.1 under the influence of fentanyl, and flow in the grey matter from 78.8 +/- 10 to 84.3 +/- 65 ml/100 g/min. Mean flow changed from 49 +/- 3.1 ml/100 g/min in the conscious state to 55.5 +/- 10 under the influence of fentathienyl, flow in the grey matter increasing from 75 +/- 9 to 81.8 +/- 14.4. Whilst there was no variation in mean flow rates under the influence of morphinomimetics, individual behaviour was very variable, in particular in the case of fentanyl, the changes produced by fentathienyl being much more homogeneous. There was no obvious modification in the distribution of regional flow by these morphinomimetics. Individual variations in flow correlated perfectly with individual variations in cerebral oxygen consumption. Vascular reactivity to CO2 was increased b morphinomimetics. In one subject, fentanyl produced a very marked increase in cerebral blood flow (+ 104 p. 100) for which no explanation could be found.
Subject(s)
Blood Pressure/drug effects , Cerebrovascular Circulation/drug effects , Fentanyl/analogs & derivatives , Fentanyl/pharmacology , Neuroleptanalgesia , Adolescent , Adult , Cerebral Cortex/blood supply , Drug Evaluation , Female , Fentanyl/administration & dosage , Humans , Male , Middle Aged , Oxygen ConsumptionABSTRACT
Etomidate or R 26490 is a new hypnotic agent produced by JANSSEN and al. in 1971. The first human experimentation was performed in 1972. The authors used Etomidate for 300 anaesthetics given for neuroradiological investigations. Two protocols were used for study: 25 anaesthetics were given with Etomidate as sole anaesthetic to outline its specific properties; 275 angiographies were performed with a combination of Etomidate and fentanyl. In protocol no. 1, the mean consumption was for 1,85 mg/kg/h, in protocol no. 2, the mean consumption was of 0,9 mg/kg/h. Pharmacological study of this drug defines it as a short acting hypnotic agent of low toxicity. Clinical observation shows cardiovascular and respiratory stability. However, frequent myoclonias were noted, when Etomidate was given as a sole anaesthetic. EEG recording and evoked response encephalography helped to outline some effects of Etomidate on central nervous system.
