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Eur J Anaesthesiol. 2012 Oct;29(10):471-6. doi: 10.1097/EJA.0b013e328357c090.

Transcranial Doppler sonography as a potential screening tool for preanaesthetic evaluation: a prospective observational study.

Author information

1
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg, Germany. axel.fudickar@uksh.de

Abstract

CONTEXT:

Intraoperative cervical spine rotation may compromise cerebral blood flow in susceptible individuals by distortion of cervical arteries.

OBJECTIVE:

To investigate the effect of five cervical spine positions on cerebral blood flow in the middle cerebral artery.

DESIGN:

Prospective observational study.

SETTING:

University hospital.

PATIENTS:

Fifty-six male and 24 female patients scheduled for general anaesthesia for routine surgery. Exclusion criteria were cranial spine pathology and cerebral vascular disease.

INTERVENTIONS:

Maximum rotation of the head to the left and right side with and without hyperextension, and hyperextension in the neutral position.

MAIN OUTCOME MEASURES:

Change of mean blood flow velocity in the middle cerebral artery measured by transcranial Doppler sonography.

RESULTS:

Age had a significant effect on mean blood flow velocity in the left middle cerebral artery in the neutral position (P = 0.047). There was a significant difference in mean blood flow velocity in the left middle cerebral artery between patients younger than 40 years and patients older than 59 years [61.2 (16.6) ml min(-1) vs. 47.7 (16.2) ml min(-1); P = 0.015]. There was a significant effect of head position on mean blood flow velocity in both the left and in the right middle cerebral arteries (P = 0.039 left, P = 0.025 right). Twenty patients had a decrease of more than 20% from their baseline mean blood flow velocity.

CONCLUSION:

Neck rotation and/or extension resulted in a significant change of blood flow in the middle cerebral artery.

PMID:
22922477
DOI:
10.1097/EJA.0b013e328357c090
[Indexed for MEDLINE]

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