• Frank Rasulo, Nicola Zugni, Simone Piva, Nazzareno Fagoni, Federico Pe, Arturo Toninelli, Stefano Calza, and Nicola Latronico.
• Department of Anesthesiology, Intensive Care and Perioperative Medicine, University of Brescia, Spedali Civili Hospital of Brescia, Brescia, Italy - frank.rasulo@gmail.com.
• Minerva Anestesiol. 2016 Aug 1; 82 (8): 850-7.

BackgroundSupraglottic airway devices (SGDs) are of current use in anesthesia practice and in emergency conditions. It has been suggested that cerebral blood flow (CBF) can decrease after SGD insertion or cuff inflation; however, it is uncertain if this reduction is caused by the SGD or the anesthetic drugs utilized for the anesthetic procedure. During minor surgery we separated CBF measurements by an adequate time interval in order to measure the distinctive changes in cerebral hemodynamics associated with anesthesia induction, SGD insertion and cuff inflation.MethodsPatients scheduled for minor surgery requiring general anesthesia and SGD placement were included. Middle cerebral artery mean flow velocity (FVm-mca) and the Pulsatility Index (PI) were measured through use of trans-cranial Doppler (TCD) at baseline, after anesthesia induction, SGD insertion and cuff inflation, once a steady cardio-circulatory state was reached and end tidal CO2 (etCO2) was within normal range.ResultsA total of 21 patients were included. Following anesthesia induction, in concomitance to a reduction in mean arterial pressure (MAP), there was a mean decrease in FVm-mca by 16.60 cm/s, P<0.005 and a mean increase in PI by 0.24, P<0.0015. MAP, FVm-mca and PI did not change significantly, neither after SGD placement (P>0.05), nor after SGD cuffing (P>0.05).ConclusionsSGD insertion and cuff inflation did not influence cerebral hemodynamics in anesthetized patients undergoing minor surgery. At normal etCO2 range, the CBF reduction with transient increase in PI was associated with anesthesia induction and not SGD insertion itself.

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