Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/14733
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Type: Journal article
Title: The effect of altered cerebral blood flow on the cerebral kinetics of thiopental and propofol in sheep
Author: Upton, R.
Ludbrook, G.
Grant, C.
Doolette, D.
Citation: Anesthesiology, 2000; 93(4):1085-1094
Publisher: Lippincott Williams & Wilkins
Issue Date: 2000
ISSN: 0003-3022
1528-1175
Abstract: BACKGROUND:Thiopental and propofol are highly lipid-soluble, and their entry into the brain often is assumed to be limited by cerebral blood flow rather than by a diffusion barrier. However, there is little direct experimental evidence for this assumption. METHODS:The cerebral kinetics of thiopental and propofol were examined over a range of cerebral blood flows using five and six chronically instrumented sheep, respectively. Using anesthesia (2.0% halothane), three steady state levels of cerebral blood flow (low, medium, and high) were achieved in random order by altering arterial carbon dioxide tension. For each flow state, 250 mg thiopental or 100 mg propofol was infused intravenously over 2 min. To quantify cerebral kinetics, arterial and sagittal sinus blood was sampled rapidly for 20 min from the start of the infusion, and 1.5 h was allowed between consecutive infusions. Various models of cerebral kinetics were examined for their ability to account for the data. RESULTS:The mean baseline cerebral blood flows for the "high" flow state were over threefold greater than those for the low. For the high-flow state the normalized arteriovenous concentration difference across the brain was smaller than for the low-flow state, for both drugs. The data were better described by a model with partial membrane limitation than those with only flow limitation or dispersion. CONCLUSIONS:The cerebral kinetics of thiopental and propofol after bolus injection were dependent on cerebral blood flow, despite partial diffusion limitation. Higher flows produce higher peak cerebral concentrations.
Keywords: Brain; Body Fluid Compartments; Animals; Sheep; Propofol; Thiopental; Anesthetics, Intravenous; Blood Flow Velocity; Cerebrovascular Circulation; Models, Biological; Computer Simulation; Female
RMID: 0001001756
DOI: 10.1097/00000542-200010000-00033
Appears in Collections:Anaesthesia and Intensive Care publications

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