CEREBRAL LACTATE EFFLUX DURING GENERAL ANAESTHESIA- A COMPARISON BETWEEN MAINTENANCE OF ANAESTHESIA WITH SEVOFLURANE AND WITH PROPOFOL INFUSION

Abstract

Sugandha Kuttanasari Remani 1 , Anwar Mohammed Ahammed

BACKGROUND Anaesthetic agents substantially reduce the global cerebral metabolic rate and blood flow. Glycolytic metabolism increases in response to ischaemic events. The aim of the study is to know whether there is any difference in lactate production with inhalational agents compared with intravenous agents for maintenance of anaesthesia. MATERIALS AND METHODS This is an observational study conducted on 60 adult patients of ASA I and II undergoing ENT and neurosurgical procedures under general anaesthesia divided into two groups of 30 each with maintenance of anaesthesia with sevoflurane and with propofol infusion, in groups I and II, respectively. Blood samples were drawn from the internal jugular vein and subjected to blood gas analysis. Statistical analysis was done and p-value was calculated. RESULTS Intravenous agents are associated with a greater degree of anaerobic glucose metabolism and hence higher cerebral lactate levels. Thus, inhalational agents are beneficial in maintaining cerebral flow by reducing anaerobic metabolism of glucose. CONCLUSION Alterations in cerebral blood flow and ischaemia are lesser with inhalational agents compared to intravenous agents.

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