Effect of inhalational anesthesia on cerebral circulation in Moyamoya disease

To clarify the effects of inhalational anesthesia on cerebral circulation in patients with Moyamoya disease, the authors measured regional cortical blood flow (CoBF), jugular bulb oxygen saturation (SjO2), and frontal regional oxygen saturation (rSO2) by near infra-red spectroscopy under total intravenous and inhalational anesthesia in 13 patients undergoing revascularization procedures. Cortical blood flow decreased in some regions under inhaled anesthesia in all cases, and the mean value decreased significantly (p<0.01). Patients' SjO2 levels rose during inhalational anesthesia in 10 of 11 cases (p<0.01). Frontal rSO2 declined in 9 of 11 cases. Regional CoBF levels may be decreased by inhaled anesthesia in patients with Moyamoya disease, and such anesthesia may provoke intracerebral steal. Total intravenous anesthesia, however, lacked these effects.