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British Journal of Anaesthesia, 2000, Vol. 85, No. 2 199-204
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Low-dose remifentanil increases regional cerebral blood flow and regional cerebral blood volume, but decreases regional mean transit time and regional cerebrovascular resistance in volunteers

I. H. Lorenz1,*, C. Kolbitsch1, M. Schocke2, C. Kremser2, F. Zschiegner1, M. Hinteregger1, S. Felber2, C. Hörmann1 and A. Benzer1

1Department of Anesthesia and Intensive Care Medicine and 2Department of Magnetic Resonance Imaging, University of Innsbruck, Innsbruck A-6020, Austria

We have used contrast media-enhanced perfusion magnetic resonance imaging MRI to measure regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), regional mean transit time (rMTT) and regional cerebrovascular resistance (rCVR) in volunteers at baseline and during infusion of remifentanil (0.1 µg kg–1 min–1). Remifentanil increased rCBF and rCBV in white and grey matter (striatal, thalamic, occipital, parietal, frontal) regions, with a parallel decrease in rMTT in those regions with the exception of occipital grey matter. rCVR was decreased in all regions studied. The relative increase in rCBF was greater than that in rCBV. Cerebral haemodynamics were increased significantly in areas less rich in µ-opioid receptors with a tendency towards more pronounced increases in rCBF and rCBV in pain-processing areas. Furthermore, interhemispheric differences in rCBF, rCBV and rMTT found prior to drug administration were almost eliminated during infusion of remifentanil. We conclude that, apart from direct and indirect cerebrovascular effects of remifentanil, these findings are consistent with cerebral excitement and/or disinhibition.

Br J Anaesth 2000; 85: 199–204

* Corresponding author


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