Clinical trial · Interventional
The Effect of Blood Pressure on Cerebral Blood Flow During Propofol Anesthesia
NCT03309917CI-TRIAL-00033960CAcompletedN/AClinicalTrials.gov clinicaltrialsProvenance
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
General anesthesia often reduces blood pressure whereby blood flow to the brain and other vital organs may become insufficient. Thus, medicine is often administered to maintain blood pressure but it is unclear at what level blood pressure should be aimed at during anesthesia. Thirty patients undergoing major abdominal surgery will be included. The study will start one hour after the start of surgery and lasts for approximately half an hour. The purpose of the study is to evaluate whether blood flow to the brain can be increased by maintaining blood pressure at a higher level than that used in clinical practice. In the study, MAP is adjusted to a high, moderate, and low level for a short time. The low level of blood pressure used in the study, corresponds to the level aimed at in clinical practice. The drug noradrenaline will be used to control blood pressure. Blood flow to the brain will be evaluated on the neck using ultrasound.
Conditions
Conditions (2)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Anesthesia, General | — | UNRESOLVED | — |
| Gastrointestinal Neoplasms | Digestive System Neoplasm | ALIAS | 0.90 |
Interventions
Interventions (3)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| MAP set at 60-65 mmHg for 5 min | Other | — | UNRESOLVED |
| MAP set at 70-75 mmHg for 5 min | Other | — | UNRESOLVED |
| MAP set at 80-85 mmHg for 5 min | Other | — | UNRESOLVED |
Design
Arms and outcomes
Arms (1)
- type
- EXPERIMENTAL
- label
- Changes in mean arterial pressure
- description
- The study is conducted from one hour after incision and lasts for approximately half an hour. Measurements are conducted at three levels of mean arterial pressure: * MAP set at 80-85 mmHg for 5 min. * MAP set at 70-75 mmHg for 5 min. * MAP set at 60-65 mmHg for 5 min. Blood pressure control is by infusion of noradrenaline. When the evaluations have been conducted blood pressure control is according to clinical practice. Measurements include internal carotid artery blood flow, mean arterial pressure, heart rate, stroke volume, frontal lobe and muscle oxygenation, depth of anesthesia, and arterial and central venous blood gas variables.
- interventionNames
- Other: MAP set at 80-85 mmHg for 5 min
- Other: MAP set at 70-75 mmHg for 5 min
- Other: MAP set at 60-65 mmHg for 5 min
Primary outcomes (1)
- measure
- Change in internal carotid artery blood flow when mean arterial pressure (MAP) is set to 80-85 and 60-65 mmHg
- timeFrame
- Values are recorded during 2 min at 2 time points; when MAP is set to 80-85 and 60-65 mmHg during propofol anesthesia as part of the study. The evaluations are separated by approximately 30 min
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 19 Years
Show eligibility criteria text
Inclusion Criteria: * Patient planned for Whipple's surgery or total pancreatic resection * Age \> 18 years Exclusion Criteria: * No informed consent * Alcohol intake ≥ 420 g / week * Beard on the neck * Visualization of the internal carotid artery not possible, e.g. due to high placement of the bifurcation * Stenosis that obstructs ≥ 16% of the internal carotid artery * Cardiac disease, including congestive heart failure (NYHA II-IV), myocardial infarction, valvular heart disease or atrial fibrillation * Neurologic disease considered to affect cerebral blood flow, including dementia, epilepsy, and apoplexy * Intake of moclobemide, isocarboxazid or tricyclic antidepressants
References
Publications (33)
- BACKGROUNDChoi WS, Samman N. Risks and benefits of deliberate hypotension in anaesthesia: a systematic review. Int J Oral Maxillofac Surg. 2008 Aug;37(8):687-703. doi: 10.1016/j.ijom.2008.03.011. Epub 2008 Jun 3. PMID 18511238
- BACKGROUNDEderberg S, Westerlind A, Houltz E, Svensson SE, Elam M, Ricksten SE. The effects of propofol on cerebral blood flow velocity and cerebral oxygen extraction during cardiopulmonary bypass. Anesth Analg. 1998 Jun;86(6):1201-6. doi: 10.1097/00000539-199806000-00011. PMID 9620503
- BACKGROUNDEvans DH. On the measurement of the mean velocity of blood flow over the cardiac cycle using Doppler ultrasound. Ultrasound Med Biol. 1985 Sep-Oct;11(5):735-41. doi: 10.1016/0301-5629(85)90107-3. PMID 2932831
- BACKGROUNDGreenfield JC Jr, Tindall GT. Effect of norepinephrine, epinephrine, and angiotensin on blood flow in the internal carotid artery of man. J Clin Invest. 1968 Jul;47(7):1672-84. doi: 10.1172/JCI105858. PMID 4298077
- BACKGROUNDKaisti KK, Metsahonkala L, Teras M, Oikonen V, Aalto S, Jaaskelainen S, Hinkka S, Scheinin H. Effects of surgical levels of propofol and sevoflurane anesthesia on cerebral blood flow in healthy subjects studied with positron emission tomography. Anesthesiology. 2002 Jun;96(6):1358-70. doi: 10.1097/00000542-200206000-00015. PMID 12170048
- BACKGROUNDKETY SS, KING BD, HORVATH SM, JEFFERS WS, HAFKENSCHIEL JH. The effects of an acute reduction in blood pressure by means of differential spinal sympathetic block on the cerebral circulation of hypertensive patients. J Clin Invest. 1950 Apr;29(4):402-7. doi: 10.1172/JCI102272. No abstract available. PMID 15415440
- BACKGROUNDKristensen SD, Knuuti J, Saraste A, Anker S, Botker HE, Hert SD, Ford I, Gonzalez-Juanatey JR, Gorenek B, Heyndrickx GR, Hoeft A, Huber K, Iung B, Kjeldsen KP, Longrois D, Luscher TF, Pierard L, Pocock S, Price S, Roffi M, Sirnes PA, Sousa-Uva M, Voudris V, Funck-Brentano C; Authors/Task Force Members. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J. 2014 Sep 14;35(35):2383-431. doi: 10.1093/eurheartj/ehu282. Epub 2014 Aug 1. No abstract available.