Effect of a Bolus Dose of an Analgetic on Subdural Intracranial Pressure and Cerebral Haemodynamics During General Anaes
Many studies regarding the effects of synthetic opioids on ICP, arteriovenous oxygen difference, mean arterial blood pressure and the CO2 reactivity have been carried out. Contradictory results have been obtained. This, however, is most likely due to diff
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Georg E. Cold ⋅ Niels Juul (Eds.)
Monitoring of Cerebral and Spinal Haemodynamics During Neurosurgery With collaboration of Mads Rasmussen, Alp Tankisi, Helle Bundgaard, Lise Schlünzen, Birgitte Duch, Etienne Karatasi, Lisbeth Krogh, Jens-Aage Kølsen-Petersen, Karsten Skovgaard Olsen, Claus Mosdal and Bent Lob Dahl
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Georg E. Cold
Niels Juul
Hojkolvej 2 8210 Aarhus V Denmark
Department of Neuroanaesthesia Aarhus University Hospital Norrebrogade 44 8000 Aarhus C Denmark
ISBN 978-3-540-77872-1
e-ISBN 978-3-540-77873-8
DOI 10.1007/978-3-540-77873-8 Library of Congress Control Number: 2008920954 © 2008 Springer-Verlag Berlin Heidelberg This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer Verlag. Violations are liable to prosecution under the German Copyright Law. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Cover design: Frido Steinen-Broo, eStudio, Calamar, Spain Typesetting and Production: le-tex publishing services oHG, Leipzig, Germany Printed on acid-free paper 987654321 springer.com
Preface
Make the best of it (Samuel Pepys)
Everyone interested in neuroanaesthesia talks about intracranial pressure (ICP), but in daily clinical practice nobody measures it during craniotomy. This was our view ten years ago, when Dr. Cold was asked by an international congress to make a speech with the title: Is hyperventilation mandatory during craniotomy? Panic triggered our intellectual resources and, thanks to our good friends the neurosurgeons, we soon performed the first measurement of subdural ICP. Very soon we were convinced that perioperative subdural ICP measurement not only gave important information concerning the occurrence of brain swelling after opening of dura, but also it was possible to follow the effects of ICP-reducing procedures such as hyperventilation, indomethacin, mannitol treatment and surgical decompression by drainage of ventricular fluid or cystic tumours. Moreover, we were convinced that perioperative ICP measurement combined with gas analysis from arterial and jugular venous blood would provide us with important neurophysiological information, instead of the prevailing feeling that the
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