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Phenylephrine Usage During Anesthesia in Concussed Patients Undergoing Orthopedic Surgery: A Retrospective Cohort
Jonathan Henning1, Brian Villa1, Parker Penny1
1Anesthesiology, University of South Florida Morsani College of Medicine, Tampa, USA.
Cureus
|March 18, 2025
Summary
Concussion patients with loss of consciousness (LOC) needed more phenylephrine during orthopedic surgery anesthesia. This study highlights LOC
Area of Science:
- Anesthesiology
- Neurology
- Trauma Surgery
Background:
- Concussion can alter cerebral blood flow autoregulation.
- Understanding these physiological changes is crucial for patient management.
- Phenylephrine is a common vasopressor used during general anesthesia.
Purpose of the Study:
- To investigate if concussed patients require higher phenylephrine dosage or frequency during orthopedic surgery.
- To determine if loss of consciousness (LOC) associated with concussion impacts phenylephrine requirements.
- To compare vasopressor usage in concussed patients versus non-concussed controls.
Main Methods:
- Retrospective review of 179 patients (61 concussed, 118 controls) undergoing emergent orthopedic surgery.
- Concussed patients were stratified by the presence or absence of LOC.
- Phenylephrine usage (dosage and frequency) was analyzed using chi-square, Kruskal-Wallis, and Dunn's tests.
Main Results:
- No significant difference in phenylephrine usage was found between all concussed patients and controls.
- Concussed patients with LOC required significantly higher doses of phenylephrine compared to controls.
- Phenylephrine was the most frequently used vasopressor across all surgical groups.
Conclusions:
- This study is the first to examine the link between concussion, LOC, and vasopressor needs in anesthesia.
- Concussion with LOC is associated with an increased requirement for phenylephrine during general anesthesia.
- Findings suggest altered physiological responses in concussed patients with LOC impacting anesthetic management.
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