Document Detail

Pressure inside the neuroendoscope: correlation with epidural intracranial pressure during neuroendoscopic procedures.
MedLine Citation:
PMID:  20479667     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: During neuroendoscopic procedures, pressure inside the neuroendoscope (PIN) monitored through the irrigation channel correlates with the occurrence of postoperative complications. Our aim was to analyze the reliability of PIN measurement as a surrogate for intracranial pressure (ICP) by comparing PIN with simultaneously epidural ICP measurement as the standard. METHODS: Seventeen consecutive patients undergoing neuroendoscopy were studied prospectively. Type and length of procedure and PIN and epidural ICP values during neuroendoscopy were recorded. Lin's concordance coefficient and Bland-Altman analysis of agreement were used to assess correspondence between the 2 systems. RESULTS: A consistent relation between PIN and epidural ICP waveforms was observed during neuroendoscopic navigation. A strong Pearson correlation between PIN and epidural ICP data were found in 15 patients. Epidural ICP values were systematically higher than PIN values in 15 patients. Lin concordance coefficients showed moderate global agreement between the 2 methods, at 0.58 (95% confidence interval, 0.577-0.592). In 6 cases (35.2%) concordance was good according to this analysis, in 7 cases (41.2%) agreement was moderate/fair, and in 4 cases (23.5%) agreement was poor. The Bland-Altman analysis of patient data showed good agreement between the PIN and epidural ICP measurements for most patients, although discrepancies were greater at higher ICP values for 11 patients. Bland-Altman analysis of the complete dataset, after the normalization of individual's measurements, showed good overall agreement. CONCLUSIONS: PIN measurement seems useful for evaluating ICP changes related to neuroendoscopic procedures and seems to be more consistent than epidural ICP at high pressures.
Lydia Salvador; Ricard Valero; Jesús Carazo; Luis Caral; José Rios; Enrique Carrero; Javier Tercero; Nicolas de Riva; Paola Hurtado; Enrique Ferrer; Neus Fábregas
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  22     ISSN:  1537-1921     ISO Abbreviation:  J Neurosurg Anesthesiol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-15     Completed Date:  2010-09-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  240-6     Citation Subset:  IM    
Department of Anesthesiology, Hospital Clínic de Barcelona, Barcelona, Spain.
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MeSH Terms
Anesthesia, General
Epidural Space / physiology*
Intracranial Pressure / physiology*
Linear Models
Middle Aged
Neurosurgical Procedures*
Prospective Studies
Young Adult

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