• Clin Physiol Funct Imaging · Nov 2011

    Randomized Controlled Trial

    The effect of phenylephrine on arterial and venous cerebral blood flow in healthy subjects.

    • Shigehiko Ogoh, Kohei Sato, James P Fisher, Thomas Seifert, Morten Overgaard, and Niels H Secher.
    • Department of Biomedical Engineering, Toyo University, Kawagoe-Shi, Saitama, Japan. ogoh@toyo.jp
    • Clin Physiol Funct Imaging. 2011 Nov 1;31(6):445-51.

    AimSympathetic regulation of the cerebral circulation remains controversial. Although intravenous phenylephrine (PE) infusion reduces the near-infrared spectroscopy (NIRS)-determined measure of frontal lobe oxygenation (S(c) O(2) ) and increases middle cerebral artery mean blood velocity (MCA V(mean) ), suggesting α-adrenergic-mediated cerebral vasoconstriction, this remains unconfirmed by evaluation of arterial and venous cerebral blood flow.MethodsWe determined S(c) O(2) , MCA V(mean) , and right internal carotid artery (ICA) and internal jugular venous (IJV) blood flow (duplex ultrasound) during infusion of PE in eight supine young healthy men [26 (3) years, 177 (7) cm and 74 (8) kg; mean (SD)].ResultsCompared with saline, during infusion of PE, mean arterial pressure increased 26 ± 3% (mean ± SE) and MCA V(mean) by 4·8 ± 1·9% (P<0·05), while S(c) O(2) decreased by 13·7 ± 3·7% (P<0·05) with no significant changes in the arterial oxygen or carbon dioxide tensions. ICA blood flow did not change significantly in response to PE administration (351 ± 12 versus 373 ± 21 ml min(-1) ; P = 0·236), while IJV blood flow increased (443 ± 57 versus 507 ± 58 ml min(-1) ; P = 0·023).ConclusionsThese findings confirm that PE induces a reduction in S(c) O(2) measured by NIRS and causes an increase in MCA V(mean) indicative of cerebral arterial vasoconstriction, although ICA was preserved and IJV increased. These results suggest that a decrease in S(c) O(2) during infusion of PE reflects an altered cerebral contribution of arterial versus venous blood to the NIRS signal, although we cannot rule out that an effect of PE on skin blood flow is important.© 2011 The Authors. Clinical Physiology and Functional Imaging © 2011 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

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