Phenylephrine increases regional cerebral blood flow following hemorrhage during isoflurane-oxygen anesthesia

Abstract

Using the radioactive microsphere technique regional cerebral blood flow (rCBF) and total CBF (tCBF) were examined in rats at three time periods: baseline (CBF1) during 1.5 MAC inspired isoflurane-oxygen anesthesia, CBF2; during 1.5 MAC inspired isoflurane anesthesia combined with hypotension induced by hemorrhage and CBF3; during isoflurane and hemorrhage plus phenylephrine infused to restore mean arterial pressure (MAP) to baseline. For CBF1 MAP was 89 ± 3 mmHg (mean ± SEM, n = 9) with Pa(CO2) 44 ± 1 mmHg. For CBF2 following graded hemorrhage MAP was 48 ± 2 mmHg and Pa(CO2) 43 ± 1 mmHg. For CBF3 MAP was 93 ± 2 and Pa(CO2) 45 ± 1 mmHg, following infusion of phenylephrine (PE) at 13.9 ± 4.0 μg · kg-1 · min-1. Total CBF1 was 1.84 ± 0.18 ml · g-1 · min-1, tCBF2 1.32 ± 0.09 ml · g-1 · min-1 (P < 0.05 vs. tCBF1) and tCBF3 2.60 ± 0.18 (P < 0.05 vs. tCBF1 and 2) For tCBF3 hemoglobin concentration had decreased 23% from 14.2 ± 0.2 g · 100 ml-1 to 11.0 ± 0.5 g · 100 ml-1 (P < 0.05). Regional CBF decreased significantly in seven of 12 regions examined from CBF 1 to CBF2 and was significantly higher in all regions for CBF3. For CBF1-3 infratentorial blood flow (cerebellar and brain stem) were significantly higher than flows to the supratentorial structures (cerebral cortical and basal ganglia). During isoflurane anesthesia, phenylephrine infused to support MAP following hemorrhagic hypotension effectively maintains rCBF and tCBF. There is no indication that phenylephrine infused to increase MAP following hemorrhage results in cerebral vasoconstriction in rats anesthetized with isoflurane.