AANA journal
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In selecting an anesthetic agent to be used for neurosurgical procedures, the anesthesia provider must consider the agent's effects on intracranial pressure (ICP), cerebral blood flow (CBF), and cerebral metabolic rate of oxygen consumption (CMRO2). The anesthetic of choice for neurosurgical procedures for many decades has been thiopental. It meets the strict requirements for neurosurgical procedures because it protects the brain from ischemia and herniation by lowering ICP through decreases in CBF and CMRO However, new drugs, including etomidate and propofol, have been introduced that offer anesthesia providers comparable neuroprotective actions plus other positive attributes. ⋯ The literature showed that all 3 anesthetic agents provide favorable neurological protection. Each drug has some undesirable side effects. Knowledge of these side effects and the patient's medical and surgical history can help CRNAs determine the most suitable anesthetic in specific situations.
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Droperidol has been an efficacious, inexpensive butyrophenone used since the early 1970s to prevent or treat postoperative nausea and vomiting. Because of reports of sudden cardiac death in patients receiving droperidol, the US Food and Drug Administration (FDA) recently placed significant restrictions on its administration. ⋯ Haloperidol is another butyrophenone with antiemetic properties but without the FDA restrictions. This article reviews the literature regarding haloperidol and supports its use as a safe substitute for droperidol in the prevention and treatment of postoperative nausea and vomiting.