Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1980
Comparative Study Clinical TrialPediatric premedication: atropine or not?
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We have studied the effects of enflurane on intracranial pressure (ICP) in 9 neurosurgical patients, whose ICP was continuously monitored for therapeutic or diagnostic purposes. The control ICP was under 15 Torr in 5 cases, under 20 Torr in 3 cases and of 25 Torr in one case. In order to achieve stable ventilatory conditions, the patients were kept under controlled ventilation, breathing a mixture of 60 to 70% nitrous oxide and oxygen. ⋯ The overall changes, however, are not significant. There is a small significant decrease of MAP and CPP under 2% enflurane when compared to control, of probably no clinical importance (under 10% change). Our results do not show that enflurane is entirely without effect on ICP, but we think that 1 to 2% enflurane may be used in neuroanesthesia with a reasonable margin of safety, in association with slight hyperventilation and other means or reducing ICP, in accordance to clinical requirements.
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Acta Anaesthesiol Belg · Jan 1980
Effect of 1% enflurane (Ethrane) anesthesia on cerebral blood flow and metabolism in neurosurgical patients during normo- and hyperventilation.
We have measured the CBF in ten neurosurgical patients. A first measurment was made during anesthesia with nitrous oxide 70% and a second with nitrous oxide 70% + 1% enflurane, both at a PaCO2 of 40 Torr. A third measurement was performed also with nitrous oxide + 1% enflurane, but at a PaCO2 of 30 Torr. ⋯ There were little differences in lactate and pyruvate cerebral metabolic rates, all values remaining within normal ranges. In conclusion, we believe that enflurane is a favorable anesthetic agent for neurosurgical operations at the concentration of 1%, CMRO2 is reduced, there is no significant effect on cerebral blood vessels, CBF and CVR do not change. However, a complementary use of hypocapnia may reduce CBF to dangerously low levels, if at the start, it shows already a pathological decrease and if hyperventilation is applied at a marked degree.
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Acta Anaesthesiol Belg · Jan 1980
Comparative StudyA comparison between sodium nitroprusside and trimetaphan-induced hypotension.
Hypotension induced with nitroprusside is compared with the same degree of hypotension produced by trimetaphan in terms of cerebral perfusion, oxygenation and brain electrical activity. It is concluded that in all these respects nitroprusside has advantages over trimetaphan. On the other hand, nitroprusside increases intracranial pressure whilst trimetaphan does not. Both these drugs have a place in hypotension for neurosurgery.