Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1998
Randomized Controlled Trial Comparative Study Clinical Trial-The effect of ondansetron on intracranial pressure and cerebral perfusion pressure in neurosurgical patients-.
To determine the effect of ondansetron on intracranial pressure (ICP), mean arterial pressure (MAP) and cerebral perfusion pressure (CPP). ⋯ Intravenous administration of 8 mg ondansetron affects neither cerebral hemodynamics nor ICP.
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Ann Fr Anesth Reanim · Jan 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Brachial plexus anesthesia via an axillary route for emergency surgery: comparison of three approach methods].
To compare three techniques of brachial plexus blockade for emergency surgery of the upper limb. ⋯ As these three techniques for brachial plexus block in emergency surgery are comparable, no one can be recommended instead of the others.
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The question as to whether the head and trunk of neurosurgery patients should be elevated remains controversial. This question is particularly important when intracranial hypertension is present. Head up position may have beneficial effects on intracranial pressure (ICP) via changes in mean arterial pressure (MAP), airway pressure, central venous pressure and cerebro spinal fluid displacement. ⋯ In most patients with intracranial hypertension, head and trunk elevation up to 30 degrees is useful in helping to decrease ICP, providing that a safe CPP of at least 70 mmHg or even 80 mmHg is maintained. Patients in poor haemodynamic conditions are best nursed flat. CPP is thus the most important factor in assessment and monitoring when considering head elevation in patients with increased ICP.