Elderly Clinical Trial
Official title:
Evaluation of Transcranial Doppler Vasoconstrictor Vasoreactivity During General Anesthesia in Hypertensive Patients
During a general anesthesia, people over 65 years old and hypertensive, have a modification of the vasoreactivity and their cerebral blood flow under vasoconstrictor such as norepinephrine or phenylephrine. We study the variation of the average velocity of the average cerebral artery under vasoconstrictor and during a modification of End Tidal CO2 (EtCO2) by transcranial Doppler.
General anesthesia induces a sympathetic block frequently leading to hypotension, especially
in elderly and hypertensive patients. Currently, Phenylephrine (PE) and Norepinephrine (NE)
are commonly used in clinical practice to address this arterial pressure drop. Their
cardiovascular effects are not exactly the same, even though they both increase mean blood
pressure.
Maintenance of mean arterial pressure is not the only hemodynamic goal during general
anesthesia in the elderly. Cognitive disorders have been demonstrated during post-anesthetic
awakening.
Cerebral hemodynamics is assessed by analyzing the speed of blood flow in the middle cerebral
artery using transcranial Doppler (DTC). It measures the systolic and diastolic speed as well
as the pulsatility index, which are predictive factors for lowering cerebral blood flow.
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