Results: Peritumoral mean ± SD cerebral metabolic rate of oxygen values before and after vasopressor (ephedrine, 67.0 ± 11.3 and 67.8 ± 25.7 μmol · 100 g−1 · min−1; phenylephrine, 68.2 ± 15.2 and 67.6 ± 18.0 μmol · 100 g−1 · min−1) showed no intergroup difference (difference [95% CI], 1.5 [−13.3 to 16.3] μmol · 100 g−1 · min−1 [P = 0.839]). Corresponding contralateral hemisphere cerebral metabolic rate of oxygen values (ephedrine, 90.8 ± 15.9 and 94.6 ± 16.9 μmol · 100 g−1 · min−1; phenylephrine, 100.8 ± 20.7 and 96.4 ± 17.7 μmol · 100 g−1 · min−1) showed no intergroup difference (difference [95% CI], 8.2 [−2.0 to 18.5] μmol · 100 g−1 · min−1 [P = 0.118]). Ephedrine significantly increased cerebral blood flow (difference [95% CI], 3.9 [0.7 to 7.0] ml · 100 g−1 · min−1 [P = 0.019]) and regional cerebral oxygen saturation (difference [95% CI], 4 [1 to 8]% [P = 0.024]) in the contralateral hemisphere compared to phenylephrine. The change in oxygen extraction fraction in both regions (peritumoral difference [95% CI], −0.6 [−14.7 to 13.6]% [P = 0.934]; contralateral hemisphere difference [95% CI], −0.1 [− 12.1 to 12.0]% [P = 0.989]) were comparable between groups.
Conclusions: The cerebral metabolic rate of oxygen changes in peritumoral and normal contralateral regions were similar between ephedrine- and phenylephrine-treated patients. In the normal contralateral region, ephedrine was associated with an increase in cerebral blood flow and regional cerebral oxygen saturation compared with phenylephrine.
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