HEMODYNAMIC STUDIES ON THE VERTEBRAL ARTERY SYSTEM DURING THE VERTEBRAL ARTERIAL SURGERY Yoshikazu Okada 1 , Takeshi Shima 1 , Masahiro Nishida 1 , Tohru Yamada 1 , Kanji Yamane 1 , Tetsuro Fukui 2 , Akira Yoshida 2 1Department of Neurosurgery, Chugoku Rousai Hospital 2Department of Anesthesiology, Chugoku Rousai Hospital Keyword: vertebral artery , electromagnetic flow meter , vertebrobasilar insufficiency , sympathetic nerve , autoregulation pp.591-596
Published Date 1990/6/1
DOI https://doi.org/10.11477/mf.1406900069
  • Abstract
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Few hemodynamic studies on the vertebral artery system in the human can be seen. The authors measured the vertebral arterial blood flow (VAF) with an electromagnetic flow meter in 45 patients who obtained vertebral arterial surgeries. The patients showing vertebrobasilar insufliciecy such as vertigo and drop attack had serious kinking and stenosis at the first portion of the vertebral artery. The effects of induced hypotension by trimethaphan camsilate, induced hypertension by phenylephrine, cervical epidural anesthesia and induced hypertension under epidural anesthesia on the VAF were investigated.

During the control state, mean systemic arterial blood pressure (SABP), mean VAF were 97 mmHg and 54 ml/min, respectively. The effects of varied SPBP were analyzed by (Δmean VAF/mean VAF)/ (Δmean SABP/mean SABP), (ΔV/ ΔS).

The Δmean VAF and Δmean SABP indicated varied mean values of VAF and SABP, respec-tively. Mean SABP was varied significantly by about 25% in each method. The ΔV/ΔS in induced hypotension, induced hypertension, epidural anes-thesia and induced hypertension under epidural anesthesia were -0.05, 0.07, 0.90 and 0.61, re-spectively, on the average. Induced hypotension by epidural anesthesia and induced hypertension under epidural anesthesia presented significant changes in mean VAF.

This study suggests that the vertebral arterial system has excellent autoregulatory response tovaried SABP by trimethaphan and phenylephrine. Further, the cervical sympathetic nervous system has an important role in this vertebral autoregula-tory response.

Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.


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