Cardiovascular and cerebrovascular effects of the applied Valsalva manoeuvre in anaesthetized neurosurgical patients.

Publication/Presentation Date

3-1-1994

Abstract

We examined the effects of Valsalva's manoeuvre and its four phase on heart rate, central venous pressure (CVP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP), and laser Doppler cerebellar cortical blood flow (CBF). Brief Valsalva manoeuvres increased CVP and markedly decreased MAP. Cerebral perfusion pressure significantly (P < or = 0.01, Dunnett's test) decreased during phases 2 and 3 of the Valsalva manoeuvre. Cortical blood flow closely paralleled CPP; CBF decreased to 59% of control during phase 2 and to 57% of control during phase 3 of the Valsalva manoeuvre. The MAP, CPP, and CBF all returned to baseline levels during phase 4 (the overshoot phase) of the Valsalva manoeuvre, and were not significantly greater than control. No autoregulatory change in cerebrovascular resistance occurred throughout the Valsalva manoeuvre. These results suggest that brief Valsalva manoeuvres, as employed during neurosurgical procedures, mainly confirm venous haemostasis, but must be used cautiously due to the marked haemodynamic changes.

Volume

11

Issue

2

First Page

81

Last Page

87

ISSN

0265-0215

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

8174539

Department(s)

Administration and Leadership

Document Type

Article

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