Articles: general-anesthesia.
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The two major neurological complications of subarachnoid haemorrhage (SAH) due to an intracranial aneurysm are rebleeding and delayed cerebral ischaemia related to cerebral vasospasm. The best way to prevent rebleeding is early surgery. Even when surgery is performed within the first 72 hours posthaemorrhage, the risk of cerebral ischaemia due to vasospasm is high. ⋯ To conclude, together with lumbar CSF drainage and transient clipping, the anaesthetic management of the patients should include: maintenance of the arterial blood pressure close to its preoperative level, maintenance of PaCO2 between 30 and 35 mmHg and of normovolaemia through replacement of fluid and blood losses. After completion of surgery, recovery from anaesthesia should be rapid to allow fast diagnosis of neurological complications. The monitoring of the status of consciousness is the key of the diagnosis of early postoperative complications.
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Tijdschr Gerontol Geriatr · Oct 1993
Review[The role of general or regional anesthesia in the etiology of cognitive disorders in elderly subjects. Literature review].
In the eighties and nineties, eighteen papers were published concerning the influence of general or regional anaesthesia on mental function of elderly patients. In both groups mental changes can be found in the immediate post-operative period, but not on the long term. Analysis of these studies shows a relation between postoperative mental changes and, for example, high doses of drugs, a low preoperative level of mental performance or other factors, associated with personality and environment of the patient.