tailieunhanh - Anesthesiology in clinical (Sixth edition): Part 2

(BQ) Continued part 1, part 2 of the document Anesthesiology in clinical (Sixth edition) has contents: Kidney physiology & anesthesia, anesthesia for genitourinary surgery, anesthesia for orthopedic surgery, obstetric anesthesia, pediatric anesthesia, geriatric anesthesia, peripheral nerve blocks,. and other contents. Invite you to refer. | CHAPTER 27 Anesthesia for Neurosurgery KEY CONCEPTS Regardless of the cause intracranial masses present symptoms and signs according to growth rate location and intracranial pressure. Slowly growing masses are frequently asymptomatic for long periods despite relatively large size whereas rapidly growing ones may present when the mass remains relatively small. Computed tomography and magnetic resonance imaging scans should be reviewed for evidence of brain edema midline shift greater than cm or ventricular displacement or compression. Operations in the posterior fossa can injure vital circulatory and respiratory brainstem centers as well as cranial nerves or their nuclei. o Venous air embolism can occur when the pressure within an open vein is subatmospheric. These conditions may exist in any position and during any procedure whenever the wound is above the level of the heart. o Optimal recovery of air following venous air embolism is provided by a multiorificed catheter positioned at the junction between the right atrium and the superior vena cava. Confirmation of correct catheter positioning can be accomplished by intravascular electrocardiography radiography or transesophageal echocardiography. In a patient with head trauma correction of hypotension and control of any bleeding take precedence over radiographic studies and definitive neurosurgical treatment because systolic arterial blood pressures of less than 80 mm Hg predict a poor outcome. @ Sudden massive blood loss from injury to the great vessels can occur intraoperatively with adjacent thoracic or lumbar spine procedures. downloaded from Anesthetic techniques must be modified in the presence of intracranial hypertension and marginal cerebral perfusion. In addition many neurosurgical procedures require patient positions eg sitting prone that further complicate management. This chapter applies the principles developed in Chapter 26 to the anesthetic care of neurosurgical patients. .