Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 1996
Mild resuscitative hypothermia and outcome after cardiopulmonary resuscitation.
Recovery without residual neurological damage after cardiac arrest with global cerebral ischemia is still a rare event. Severe impairment of bodily or cognitive functions is often the result. The individual, emotional, and social aspects of brain damage and rehabilitation are seldom taken into account. ⋯ For accurate temperature monitoring, however, a central pulmonary artery thermistor probe should be inserted. Temperature monitoring is needed to avoid temperature < 30 degrees C. Mild hypothermia may prove to be an important and secure component for cerebral preservation and resuscitation during and after global ischemia; it may also prove to be a useful method of cerebral resuscitation after global ischemic states, thereby promoting the prevention of neuromental diseases.
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J Neurosurg Anesthesiol · Jan 1996
Comparative StudyA comparison of the electrophysiologic characteristics of EEG burst-suppression as produced by isoflurane, thiopental, etomidate, and propofol.
Electroencephalogram (EEG) burst-suppression can be produced with several anesthetic agents. Discussions of burst-suppression suggest that it has been viewed by many as a relatively uniform physiologic state independent of the agent used to produce it. This view may be an oversimplification. ⋯ The cortical versus subcortical comparison revealed, for all agents, greater peak-to-peak voltage and area under the curve in the subcortex. The data indicate that the electrophysiologic characteristics of burst-suppression vary among the four agents, with the possible exception of etomidate and propofol. The data suggest that the neurophysiologic states associated with burst-suppression produced by various anesthetics should not be assumed to be uniform.
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J Neurosurg Anesthesiol · Jan 1996
Effect of desflurane anesthesia on transcortical motor evoked potentials.
The effect of the volatile anesthetic desflurane on motor evoked potentials was examined in male rats. Animals underwent cortical stimulation using small platinum ball stimulating electrodes secured on the motor cortex. To record evoked compound muscle action potentials (CMAPs), single-shock electrical stimulation was delivered to the forelimb representation of the motor cortex. ⋯ Although there was a decrease in heart rate, the results were not statistically significant (p = 0.03). No significant difference in the onset latency or the duration of the CMAP was noted at different concentrations of the anesthetic. We conclude that desflurane anesthesia significantly alters the amplitude of the muscle response evoked by motor cortex stimulation in experimental animals.
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J Neurosurg Anesthesiol · Jan 1996
Comparative Study Clinical Trial Controlled Clinical TrialThe bispectral index during induction of anesthesia with midazolam and propofol.
This study evaluated the bispectral index as an indicator of anesthetic depth in relation to the cardiovascular response to intubation. Two treatments were compared: group 1 (n = 8) received propofol for induction of anesthesia (2 mg/kg bolus followed by an infusion of 0.20 mg/kg-1/min-1, group 2 (n = 8) was given 90 micrograms/kg midazolam 2 min before, followed by anesthesia with half-strength propofol (1 mg/kg bolus with infusion of 0.10 mg/kg-1/min-1). The bispectral index of the electroencephalogram, blood pressure, and heart rate were measured under unanesthetized conditions, during anesthetic induction, intubation, and a 15-min period after intubation. ⋯ Throughout the rest of the surgery, more propofol was used in group 1 (77 +/- 14 micrograms/kg-1/min-1) than in group 2 (42 +/- 14 micrograms/kg-1/min-1). These results show that the decrease in bispectral index provides an indication of the blood pressure increase to intubation during propofol anesthesia. Midazolam pretreatment did not attenuate the cardiovascular response to intubation but did decrease propofol use during surgery.
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J Neurosurg Anesthesiol · Jan 1996
Comparative Study Clinical Trial Controlled Clinical TrialThe effects of surgical stimulation on intracranial hemodynamics.
This study investigates the effects of surgical stimulation on cerebral blood flow velocity using transcranial Doppler sonography (TCD) in 1 and 2 maximum alveolar concentration (MAC) isoflurane anesthetized patients. Sixty ASA I and II patients undergoing breast surgery were studied. Anesthesia was maintained with 0.6% isoflurane (groups 1 and 2) or 1.2% isoflurane (groups 3 and 4) and nitrous oxide in oxygen (FIO2, 0.33). ⋯ These data show that cerebral blood flow velocity increases with surgical stimulation in 1 and 2 MAC isoflurane-anesthetized patients. This is not a function of changes in MAP. These data suggest that surgical stimulation increases cerebral blood flow, possibly because of arousal.