Mout, G.A. (2019) Changes in flow velocity of the middle cerebral artery with epidural analgesia : A study on the practical, daily use of transcranial Doppler in clinical setting. thesis, Medicine.
Full text available on request.Abstract
Although Transcranial Doppler (TCD) has been used for many years, there has recently been a renewed interest in its use as a neuromonitoring device in clinical setting, especially for changes in cerebral perfusion. This study aimed to add to this by examining the changes in cerebral blood flow during epidural analgesia. Systemic blood flow and pressure decrease with epidural analgesia. This effect has not been demonstrated in the cerebral circulation. We used transcranial Doppler (TCD) to measure blood flow velocity in the middle cerebral artery in patients who were treated with epidural analgesia after a thoracic operation. Blood flow velocity was measured pre- and postoperatively. The raw data was processed using Neuromon software and the parameters were age corrected using standardized zscores. We observed an increase in TCD parameters 24 hours after surgery, with a decrease in systemic hemodynamic parameters. After removal of the epidural catheter, all parameters returned to baseline values. We therefore concluded that in our group of patients cerebral autoregulation was not affected by epidural analgesia. Apart from this prospective investigation, a retrospective study was performed on the effect of vasopressors on changes in cerebral blood flow velocity from data of the Radboud UMC (Nijmegen). We observed a decreasing sys 2 in the placebo group, similar to results from an earlier investigation. However, there was no difference between placebo and noradrenaline or phenylephrine. The vasopressin group showed a decrease in TCD parameters compared to placebo. This investigation is further expanded in appendix 3.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervised by: and Loef, Dr. B. and department of Intensive Care, Martini Ziekenhuis Groningen and Schaafsma, Dr. A. and department of Clinical Neurophysiology, Martini Ziekenhuis G and Reidinga, Drs. A. C. and department of Intensive Care, Martini Ziekenhuis Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:07 |
| Last Modified: | 25 Jun 2020 11:07 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2702 |
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