Document Detail


Anaesthetic requirements and stress hormone responses in acute cord-injured patients undergoing surgery of the injured spine.
MedLine Citation:
PMID:  19276914     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Neuraxial anaesthesia has been shown to produce a sedative and anaesthetic-sparing effect. The purpose of the present study was to determine the effects of acute spinal cord injury on sevoflurane requirement and stress hormone responses during spinal surgery at the level of the injury. METHODS: Thirty-five patients with traumatic complete spinal cord injury undergoing spinal surgery at the level of the injury were studied. They were grouped into quadriplegics (above C7, n = 20) and paraplegics (below T1, n = 15) according to the level of injury. Patients (n = 35) with spine trauma without neurological impairment undergoing spinal surgery at the respective level served as controls. The bispectral index score was maintained at 40-50 throughout the surgery. Measurements included end-tidal sevoflurane concentrations, mean arterial pressure, heart rate, and plasma concentrations of catecholamines and arginine vasopressin. RESULTS: During the surgery, the mean arterial pressure was significantly lower in both quadriplegics and paraplegics (P < 0.05). The heart rate did not differ significantly in the quadriplegics, but was higher in the paraplegics, compared with their controls. However, end-tidal sevoflurane concentrations and bispectral index score were comparable with controls in both quadriplegics and paraplegics. Throughout the study, the plasma arginine vasopressin concentrations were not altered, although norepinephrine and epinephrine concentrations were lower in the quadriplegics. There were no significant differences in stress hormones between the groups having thoraco-lumbar surgery. CONCLUSION: Spinal cord injury neither alters the anaesthetic requirement regardless of the level of injury during spinal surgery at the level of the injury, nor enhances arginine vasopressin release. However, it blunts catecholamine responses in quadriplegics.
Authors:
Kyung Y Yoo; Tae S Kim; Cheol W Jeong; Seok J Kim; Seong T Jeong; Seong W Jeong; Min H Shin; JongUn Lee
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  26     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-11     Completed Date:  2009-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  304-10     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, South Korea. kyyoo@jnu.ac.kr
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Anesthesia, Inhalation*
Anesthetics, Inhalation*
Arginine Vasopressin / drug effects
Blood Pressure / drug effects
Electroencephalography / drug effects
Epinephrine / blood
Female
Heart Rate / drug effects
Humans
Male
Methyl Ethers*
Middle Aged
Norepinephrine / blood
Paraplegia / physiopathology
Prospective Studies
Quadriplegia / physiopathology
Spinal Cord Injuries / surgery*
Stress, Physiological*
Tidal Volume / drug effects
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 113-79-1/Arginine Vasopressin; 28523-86-6/sevoflurane; 51-41-2/Norepinephrine; 51-43-4/Epinephrine

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