Document Detail


Venous bleeding during transsphenoidal surgery: its association with pre- and intraoperative factors and with cavernous sinus and central venous pressures.
MedLine Citation:
PMID:  9052298     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Venous bleeding during transsphenoidal surgery for resection of pituitary tumors is a common problem that interferes with the performance of the surgical procedure. In this study, data were collected prospectively from 50 patients to determine whether there were pre- or intraoperative factors (e.g., patient demographics, type and grade of pituitary tumor, intraoperative hemodynamics) associated with venous bleeding which might be used to predict its occurrence. In addition, central venous pressure (CVP), and cavernous sinus pressure (CSP) were measured in 13 patients to evaluate the relationship of these pressures to each other and to the severity of venous bleeding. During resection of the pituitary tumor, the severity of venous bleeding was graded as minimal, moderate, or severe, the latter two grades requiring therapeutic intervention. Moderate bleeding requiring intervention occurred in 15 of the 50 patients, and resolved in all cases. Moderate bleeding was not related to CSP or CVP, and no specific associated factor was observed. CSP was not correlated with CVP, and was higher than that predicted from the CVP and the position of the patient or the hydrostatic gravitational pressure gradient. These results suggest that it is not possible to predict in advance which patients will have problems with venous bleeding, but that simple therapeutic maneuvers are effective.
Authors:
H W Lee; J E Caldwell; C B Wilson; B Dodson; J Howley
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  84     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-03-26     Completed Date:  1997-03-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  545-50     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesia, University of California 94143-0648, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure
Cavernous Sinus / physiology*
Heart Rate
Hemorrhage / etiology*
Humans
Middle Aged
Pituitary Gland / surgery*
Pituitary Neoplasms / surgery*
Prospective Studies
Venous Pressure

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


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