EFFECTS OF HIGH SPINAL ANESTHESIA ON CEREBRAL CIRCULATION AND METABOLISM IN MAN12

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Abstract
The effects of hypotension produced by high spinal anesthesia on the cerebral circulation and metabolism of 13 subjects was studied and compared with the variations observed in 6 double control studies. In 9 normotensive subjects the mean arterial blood pressure fell 32% from the control level. Cerebral blood flow and cerebral O2 consumption remained unaltered. Cerebral vascular resistance decreased significantly and was responsible for the maintenance of the cerebral circulation during the high spinal induced hypotension. In 4 hypertensives, the mean arterial blood pressure fell to 50% of prespinal value and suggestive decreases were noted in the cerebral blood flow and cerebral vascular resistance. Cerebral oxygen consumption did not appear to decrease. No significant blood gas or pH changes were noted in normotensive persons. Arterial blood lactate and pyruvate were significantly elevated during high spinal anesthesia associated with hypotension. No altered utilization of these metabolites was seen.

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