Controversial Issues in Neuroanaesthesia

نویسندگان

  • LD Mishra
  • Manoj K Giri
چکیده

1. Controversies related to use of drugs in neuroanaesthesia: Controversies regarding the provision of anaesthesia for intracranial neurosurgery remain, with no ideal technique identified Despite the theoretical benefits of intravenous agents, volatile agents remain popular. In a study comparing desflurane, isoflurane and sevoflurane in a porcine model of intracranial hypertension, at equipotent doses and normocapnia, cerebral blood flow (CBF) and intracranial pressure (ICP) were greatest with desflurane and least with sevoflurane The same authors also confirmed that sevoflurane also caused least vasodilation In two separate studies, isoflurane was seen to impair autoregulation, although reversible with hyperventilation, while autoregulation was virtually intact with sevoflurane 1 – 1.2 % at normocapnia Although large studies may be needed, sevoflurane appears to be the most suitable volatile agent for neuroanaesthesia practice.

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تاریخ انتشار 2012