Journal of neurosurgical anesthesiology
-
J Neurosurg Anesthesiol · Jan 2009
In-hospital complications and mortality after elective spinal fusion surgery in the united states: a study of the nationwide inpatient sample from 2001 to 2005.
Spinal fusion surgery has increased dramatically and patients presenting for surgery are often more medically challenging. We hypothesized that advanced age and coexisting morbidities have increased in the population undergoing spinal fusion and are associated with greater risks for immediate complications and mortality. The Nationwide Inpatient Sample was retrospectively reviewed for discharges after a principal procedure code for elective spinal fusion. ⋯ Although it is known for some other forms of complex surgery, we showed that elderly and medically complex spinal fusion patients were at increased risk for in-hospital mortality and early complications. The majority of complications were operative, pulmonary, cardiovascular, or genito-urinary. Patient risk correlated with the number and nature of coexisting morbidities.
-
Propofol is widely used for neurosurgical anesthesia; however, its effects on the pial microvasculature are unknown. We therefore evaluated the direct effects of propofol on pial microvessels in rabbits. Pial microcirculation was visualized using a closed cranial window technique in 20 Japanese white rabbits. ⋯ Phenylephrine constricted and nitroglycerin dilated pial arterioles and venules. Pentobarbital did not produce either burst suppression or an isoelectric electroencephalogram. The results confirm our hypothesis: clinically relevant concentrations of propofol, that is, approximately 10 mol/L, do not dilate pial arterioles or venules.