Neurocritical Care

, Volume 12, Issue 1, pp 17–23 | Cite as

Phenylephrine but not Ephedrine Reduces Frontal Lobe Oxygenation Following Anesthesia-Induced Hypotension

  • Peter Nissen
  • Patrice Brassard
  • Thomas B. Jørgensen
  • Niels H. Secher
Original Article



Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (ScO2) following anesthesia-induced hypotension.


Following induction of anesthesia by fentanyl (0.15 mg kg−1) and propofol (2.0 mg kg−1), 13 patients received phenylephrine (0.1 mg iv) and 12 patients received ephedrine (10 mg iv) to restore mean arterial pressure (MAP). Heart rate (HR), MAP, stroke volume (SV), cardiac output (CO), and frontal lobe oxygenation (ScO2) were registered.


Induction of anesthesia was followed by a decrease in MAP, HR, SV, and CO concomitant with an elevation in ScO2. After administration of phenylephrine, MAP increased (51 ± 12 to 81 ± 13 mmHg; P < 0.001; mean ± SD). However, a 14% (from 70 ± 8% to 60 ± 7%) reduction in ScO2 (P < 0.05) followed with no change in CO (3.7 ± 1.1 to 3.4 ± 0.9 l min−1). The administration of ephedrine led to a similar increase in MAP (53 ± 9 to 79 ± 8 mmHg; P < 0.001), restored CO (3.2 ± 1.2 to 5.0 ± 1.3 l min−1), and preserved ScO2.


The utilization of phenylephrine to correct hypotension induced by anesthesia has a negative impact on ScO2 while ephedrine maintains frontal lobe oxygenation potentially related to an increase in CO.


Cerebral autoregulation Cardiac output Arterial pressure Near infrared spectroscopy Drug effect 



Cerebral blood flow


Cardiac output


Heart rate


Mean arterial pressure


Near infrared spectroscopy


Frontal lobe cerebral oxygenation


Stroke volume


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Peter Nissen
    • 1
  • Patrice Brassard
    • 1
  • Thomas B. Jørgensen
    • 1
  • Niels H. Secher
    • 1
  1. 1.Department of AnesthesiaRigshospitalet 2041, University of CopenhagenCopenhagen ØDenmark

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