ABSTRACT
The newest therapy for cerebral aneurysm is the Guglielmi detachable coil (GDC). The authors describe the anesthetic management of two patients with intraoperative subarachnoid hemorrhage during Guglielmi coil placement. Various treatments for intraoperative hemorrhage are discussed, as are other common complications that can occur during placement of intravascular, intracranial coils. The placement of a ventriculostomy was a major contributing factor in the good outcome of both patients. Consideration should be given to placement of a ventriculostomy before the GDC procedure. Although the GDC procedure offers much promise, it is not a benign procedure and has its own set of complications that will no doubt challenge the neuroanesthesiologist.
Subject(s)
Catheterization/instrumentation , Subarachnoid Hemorrhage/therapy , Anesthesia , Catheterization/methods , Humans , Intracranial Pressure , Male , Middle Aged , Subarachnoid Hemorrhage/physiopathology , Tomography, X-Ray ComputedSubject(s)
Aortic Aneurysm/surgery , Oximetry/instrumentation , Oxygen/blood , Aged , Aorta, Abdominal/surgery , Fiber Optic Technology , Humans , Male , Middle Aged , VeinsABSTRACT
The effects of transcutaneous electrical nerve stimulation on plasma and cerebrospinal fluid (CSF) levels of beta-Endorphin (beta-EP) were studied in 6 groups of pain-free patients. Different modes of TENS were applied for 20 minutes. Regardless of mode and/or frequency of the stimulation plasma and/or CSF beta-EP levels were significantly increased. Plasma and CSF responses were not correlated suggesting that TENS activates different opiatergic pathways at central and peripheral level.
