Propofol and thiopental do not interfere with regional cerebral blood flow response at sedative concentrations Journal Article


Authors: Veselis, R. A.; Feschenko, V. A.; Reinsel, R. A.; Beattie, B.; Akhurst, T. J.
Article Title: Propofol and thiopental do not interfere with regional cerebral blood flow response at sedative concentrations
Abstract: Background: Anesthetics may affect the regional cerebral blood flow (rCBF) response associated with increased brain activity in humans. rCBF was measured as auditory stimulus rate was increased during propofol and thiopental administration. Methods: After informed consent, 10 right-handed male volunteer participants (aged 33.5 ± 10.4 yr, weighing 74.5 ± 8.4 kg) received thiopental (n = 4) or propofol (n = 6) intravenously at stepwise target concentrations of propofol 1.2 and 2.5-3, or thiopental 4 and 7-9 μg/ml, representing sedative and hypnotic drug concentrations. The latter made volunteers unresponsive to voice or mild stimulation. Quantitative positron emission tomographic brain images were obtained at 0, 20, and 40 auditory words per minute at each drug concentration. Using SPM99 analysis, 10-mm spherical regions of interest were identified by peak covariation of word rate with rCBF across all conditions and drug concentrations. Individual mean rCBF responses in these and primary auditory cortex (Heschl's gyri) were obtained. Results: Significant increases in rCBF with auditory word rate occurred in temporal lobes bilaterally at baseline (significance, T = 4.95). There was no change in this response during sedation (T = 5.60). During unresponsiveness seven of 10 participants had a diminished response in the left temporal lobe (T = 3.18). Global CBF, corrected for changes in PCO2 (3%·mmHg PCO 2-1), was reduced 15% by sedation and 27% during unresponsiveness. Conclusion: The presence of propofol or thiopental does not affect the rCBF response to increasing stimulus rate during consciousness. Thus, changes in rCBF activation patterns with sedative concentrations of these drugs represent effects on brain activity itself. The neuroanatomical targets of drug effect on memory and attention may be revealed by changes in rCBF patterns associated with these cognitive activities.
Keywords: adult; controlled study; human tissue; magnetic resonance imaging; propofol; sedation; dose-response relationship, drug; temporal lobe; computer assisted emission tomography; positron-emission tomography; neuropsychological test; behavior; functional laterality; oximetry; electrocardiography; brain blood flow; cerebrovascular circulation; electroencephalogram; normal human; hypnotics and sedatives; electroencephalography; human experiment; carbon dioxide; thiopental; auditory cortex; drug brain level; auditory stimulation; acoustic stimulation; brain tomography; word recognition
Journal Title: Anesthesiology
Volume: 102
Issue: 1
ISSN: 0003-3022
Publisher: Lippincott Williams & Wilkins  
Date Published: 2005-01-01
Start Page: 26
End Page: 34
Language: English
DOI: 10.1097/00000542-200501000-00008
PUBMED: 15618783
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 20" - "Export Date: 24 October 2012" - "CODEN: ANESA" - "Source: Scopus"
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  1. Robert A Veselis
    98 Veselis
  2. Ruth A Reinsel
    78 Reinsel
  3. Timothy J Akhurst
    139 Akhurst
  4. Bradley Beattie
    131 Beattie