Document Detail

Variations in cerebral haemodynamics during irrigation phase in neuroendoscopic procedures.
MedLine Citation:
PMID:  17444310     Owner:  NLM     Status:  MEDLINE    
Not many centres measure intracranial pressure during an endoscopic procedure. However, if the irrigation fluid during endoscopy is not simultaneously drained, then some rise in intracranial pressure can be anticipated. This study was carried out to measure and monitor changes in intracranial pressure during the irrigation phase in a neuroendoscopic procedure using a Codman catheter placed in the parenchyma. Intracranial pressure was monitored in 13 patients undergoing surgical neuroendoscopic procedures under a standardised anaesthetic technique. Heart rate, mean arterial pressure, intracranial pressure and cerebral perfusion pressure were recorded at baseline and during the irrigation phase of the procedure. The heart rate during irrigation was comparable to baseline values, but the mean arterial pressure at the time of irrigation increased an average of 7 mmHg (P = 0.02). At the same time there was an average 34 mmHg increase in intracranial pressure (P < 0.001), producing an average 26 mmHg decrease in the cerebral perfusion pressure (P < 0.001) during irrigation. There was an average of four episodes of raised intracranial pressure (>25 mmHg) during the irrigation phase per patient. We suggest that the intracranial pressure be routinely monitored during neuroendoscopic procedures. Only then can the potential adverse effect of irrigation on intracranial pressure and cerebral perfusion pressure be assessed.
H Prabhakar; G P Rath; P K Bithal; A Suri; H Dash
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  35     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-20     Completed Date:  2007-06-12     Revised Date:  2007-06-26    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  209-12     Citation Subset:  IM    
Department of Neuroanaesthesiology, All India Institute of Medical Sciences, New Delhi, India.
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MeSH Terms
Blood Pressure
Brain / physiopathology,  surgery*
Cerebrovascular Circulation*
Heart Rate
Intracranial Pressure*
Irrigation / methods
Neuroendoscopy / methods*
Prospective Studies
Erratum In:
Anaesth Intensive Care. 2007 Jun;35(3):459

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

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