Effect of Inhaled Sevoflurane on Pediatric Cerebrospinal Fluid Pressure During Lumbar Puncture; Implications for Intracranial Hypertension.

Autor:	Aylward SC; Department of Neurology, Nationwide Children's Hospital, Columbus, OH, USA., Aylward BS; RTI Health Advance, RTI International, Research Triangle Park, NC, USA., Fedel GM; Department of Anesthesia, Nationwide Children's Hospital, Columbus, OH, USA.
Jazyk:	angličtina
Zdroj:	Journal of child neurology [J Child Neurol] 2024 Jan; Vol. 39 (1-2), pp. 5-10. Date of Electronic Publication: 2023 Dec 12.
DOI:	10.1177/08830738231220253
Abstrakt:	Objective: To determine influence of sevoflurane on changes in cerebrospinal fluid pressure in children presenting for lumbar puncture. Methods: Cerebrospinal fluid pressure, end tidal carbon dioxide, and end tidal sevoflurane concentration measurements were obtained at 2-minute intervals for a total of 10 minutes (T0 to T5). Because of concerns regarding patient safety and comfort, the study measurements were completed at the end of the lumbar procedure, starting with the closing pressure and when sevoflurane was stopped. Results: As end tidal sevoflurane concentration decreased, cerebrospinal fluid pressure initially increased up to T2 before decreasing back to around the initial point. There was no significant correlation between sevoflurane level and cerebrospinal fluid pressure. Both weight status and presence or absence of optic edema did not have a significant impact on pressure over time. However, there was a statistically significant difference in the cerebrospinal fluid pressure over time between those with spontaneous respirations compared to those without. Conclusions: There was no significant correlation between the end tidal sevoflurane concentration and cerebrospinal fluid pressure. Assisted ventilation did produce a statistically significant increase in cerebrospinal fluid pressure and suggests that the most accurate measurements are in those with spontaneous respirations. Competing Interests: Declaration of Conflicting InterestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. S. Aylward receives salary support from Biomarin pertaining to Batten Disease research, Biohaven Pharmaceuticals Holding Company Limited for a study on Rimegepant, and NeuroNEXT/NINDS a fellowship grant award. He also receives an honorarium as associate editor of Pediatric Neurology.
Databáze:	MEDLINE
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