RESUMEN
The choice of myorelaxation agent for rapid sequence tracheal intubation for surgical cerebral decompression is a less studied question in neuroanaesthesiology. 32 patients with cerebral trauma (GCS<8) were involved in the study. Influence of succinylcholine and rocuronium bromide on cerebral circulation, intracranial pressure, cerebral perfusion pressure and systemic haemodynamics was assessed. Rocuronium bromide in dose 0.6 mg/kg provides good conditions for tracheal intubation in 40-60 seconds and does not influence on studied parameters. Rocuronium bromide is a drug of choice for general anaesthesia in patients with traumatic cerebral compression.
Asunto(s)
Androstanoles/uso terapéutico , Anestesia General/métodos , Lesiones Encefálicas/cirugía , Hipertensión Intracraneal/fisiopatología , Intubación Intratraqueal/métodos , Fármacos Neuromusculares Despolarizantes/uso terapéutico , Androstanoles/administración & dosificación , Velocidad del Flujo Sanguíneo , Lesiones Encefálicas/complicaciones , Lesiones Encefálicas/fisiopatología , Circulación Cerebrovascular/fisiología , Femenino , Humanos , Hipertensión Intracraneal/etiología , Hipertensión Intracraneal/cirugía , Masculino , Persona de Mediana Edad , Relajación Muscular/efectos de los fármacos , Fármacos Neuromusculares Despolarizantes/administración & dosificación , Respiración Artificial , Rocuronio , Succinilcolina/administración & dosificación , Succinilcolina/uso terapéuticoRESUMEN
Effect of diprivan on cerebral blood flow, intracranial (ICP) and cerebral perfused pressure (CPP) was studied in neurosurgical patients during induction narcosis. The labored perfusion syndrome was observed in all patients during the initial stage. Infusion of diprivan at the initial stage of narcosis in a dose of 2 mg/kg led to a decrease in arterial pressure, mean arterial pressure, CPP, and ICP. During intubation ICP decreased by 3-7 mm Hg. At the stage of anesthesia stabilization ICP decreased by 27.3%, mean arterial pressure by 10%, CPP by 6%, linear blood flow velocity in the mid-cerebral artery of the intact hemisphere by 28.1% and in the involved hemisphere by 39.9%, with simultaneous leveling of cerebral blood flow between them.
Asunto(s)
Anestésicos Intravenosos/farmacología , Encéfalo/efectos de los fármacos , Circulación Cerebrovascular/efectos de los fármacos , Presión Intracraneal/efectos de los fármacos , Procedimientos Neuroquirúrgicos , Propofol/farmacología , Adulto , Anestésicos Combinados/administración & dosificación , Anestésicos Combinados/farmacología , Anestésicos Intravenosos/administración & dosificación , Lesiones Encefálicas/cirugía , Neoplasias Encefálicas/cirugía , Femenino , Fentanilo/administración & dosificación , Fentanilo/farmacología , Hemodinámica/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Propofol/administración & dosificaciónRESUMEN
Intracranial pressure, cerebral perfusion pressure, and intracerebral blood volume changes were observed in 43 patients with volumetric intracranial processes (intracranial hematomas, tumors) during general rohypnol anesthesia. Intracranial and cerebral perfusion pressures were found to correlate with intracerebral blood volume. Rohypnol anesthesia decreased intracranial pressure by 25% due to reduced arterial blood influx into the head, mechanisms responsible for autoregulation of cerebral circulation being intact.
Asunto(s)
Anestesia Intravenosa , Lesiones Encefálicas/cirugía , Encéfalo/efectos de los fármacos , Flunitrazepam , Neoplasias Supratentoriales/cirugía , Adulto , Anciano , Anestesia General/métodos , Anestesia Intravenosa/métodos , Encéfalo/fisiopatología , Encéfalo/cirugía , Lesiones Encefálicas/fisiopatología , Circulación Cerebrovascular/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Humanos , Presión Intracraneal/efectos de los fármacos , Persona de Mediana Edad , Neoplasias Supratentoriales/fisiopatologíaRESUMEN
Water-electrolyte homeostasis and its basic regulatory hormones have been studied in 36 patients with neurosurgical brain pathology during surgical interventions performed under balanced anesthesia (sodium hydroxybutyrate combined with NLA drugs). The study has revealed 3 types of reactions in hormones regulating water-electrolyte homeostasis: type I--a decrease in vasopressin (VP) concentration and renin-angiotensin-aldosterone system (RAAS) activity; type II--VP increase and RAAS activation; type III--an increase in VP content and RAAS disbalance. It has been shown that type I reaction is accompanied by marked osmotic disturbances. The impact of sodium hydroxybutyrate on RAAS is manifested in aldosterone secretion suppression.