The optimal vasopressor for ensuring organ blood flow and tissue oxygen delivery during surgery remains undetermined. This study aim to compare the effects of noradrenaline vs. phenylephrine infusion on blood flow and oxygen delivery to the brain and various other organs in anesthetized neurosurgical patients.
Clinical diagnosis of supratentorial malignant or non-malignant brain tumors. Preferably 3 cm or larger( measured as the largest diameter in any plane on MRI).
Scheduled for elective supratentorial craniotomy.
Patients aged between 18 and 75 years.
American Society of Anesthesiologists status 1-3
History of allergy or intolerance to one of the study medications.
Active treatment with monoamine oxidase inhibitors.
An American Society of Anesthesiologists (ASA)physical status IV-VI.
Pregnancy or breastfeeding.
Parallel
Noradrenalin
DrugInfusion of noradrenaline during anesthesia and surgery
Phenylephrine
DrugInfusion of phenylephrine during anesthesia and surgery
Cerebral blood flow
Blood flow measured in milliliters per minute through selected regions of the brain as determined by Positron Emission Tomography
Cerebral metabolic rate of oxygen
Cerebral oxygen consumption in selected regions of the brain as determined by Positron Emission Tomography
Blood flow through body organs in milliliters per minute as determined by Positron Emission Tomography
Blood flow in various body organs supplied by the systemic circulation
Blood pumped out by the heart per minute (cardiac output)
Cardiac output as determined by Positron Emission Tomography and/or by beat-to-beat determination by analysis of the arterial blood pressure waveform
Ischemic lesions
Ischemic lesions possibly associated with vasopressor use as detected on the postoperative MRI examination
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