Document Detail


Lumbar cerebrospinal fluid drainage for thoracoabdominal aortic surgery: rationale and practical considerations for management.
MedLine Citation:
PMID:  20522706     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Paraplegia remains one of the most devastating complications of thoracoabdominal aortic surgery and is associated with a significant increase in both morbidity and mortality. Modern aortic repair techniques use many modalities aimed at reducing the risk of spinal cord ischemia inherent with surgical management. One of these modalities that acts via optimizing spinal cord blood flow is lumbar cerebrospinal fluid (CSF) drainage. Either alone or in combination with other interventions, CSF drainage remains one of the most frequently used spinal cord protection techniques. Despite no definitive proof of efficacy for reducing spinal cord injury, there are compelling data supporting its use. However, the potential benefit of CSF drainage must be balanced against the risks associated with its use, including nerve injury during insertion, compressive neuraxial hematoma formation, intracranial hemorrhage due to excessive drainage, and infection. The optimal benefit to risk ratio can be achieved by understanding the rationale for its use and following practical management guidelines.
Authors:
Christine A Fedorow; Michael C Moon; W Alan C Mutch; Hilary P Grocott
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Publication Detail:
Type:  Journal Article; Review     Date:  2010-06-03
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  111     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-25     Completed Date:  2010-07-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  46-58     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesia, University of Manitoba, Winnipeg, Manitoba R2H2A6, Canada.
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MeSH Terms
Descriptor/Qualifier:
Analgesics, Opioid / administration & dosage,  therapeutic use
Aorta, Abdominal / surgery*
Aorta, Thoracic / surgery*
Aortic Aneurysm, Thoracic / cerebrospinal fluid,  surgery
Cerebrospinal Fluid / physiology*
Drainage*
Humans
Injections
Monitoring, Physiologic
Pain, Postoperative / drug therapy
Paraplegia / etiology,  therapy
Spinal Cord Ischemia / physiopathology,  prevention & control
Subarachnoid Space
Vascular Surgical Procedures / methods*
Chemical
Reg. No./Substance:
0/Analgesics, Opioid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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