Anesthetic Requirements and Stress Hormone Responses in Spinal Cord-Injured Patients Undergoing Surgery Below the Level of Injury
Autor: | Sung-Su Chung, Hong-Beom Bae, Jong-Un Lee, Seok-Jai Kim, Jeong-Il Choi, JaeHa Hwang, S.T. Jeong, K.Y. Yoo |
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Rok vydání: | 2006 |
Předmět: |
Adult
Male Methyl Ethers medicine.medical_specialty Minimum alveolar concentration Cord Hydrocortisone Neurosurgical Procedures Thoracic Vertebrae Sevoflurane Stress Physiological Heart rate medicine Humans Anesthesia Spinal cord injury Spinal Cord Injuries Lumbar Vertebrae business.industry Middle Aged medicine.disease Surgery Anesthesiology and Pain Medicine Blood pressure Bispectral index Anesthetic Female business medicine.drug |
Zdroj: | Anesthesia & Analgesia. 102:1223-1228 |
ISSN: | 0003-2999 |
Popis: | Neuraxial anesthesia decreases the minimum alveolar concentration. We determined the effects of spinal cord injury (SCI) on sevoflurane requirements and stress hormone response. Twenty-two chronic SCI patients undergoing surgery below the level of the injury were enrolled in the study, and 15 patients without cord injury served as control patients. Bispectral index score was maintained at 40-50. Measurements included end-tidal sevoflurane concentrations, systolic arterial blood pressure, heart rate, and plasma catecholamine and cortisol concentrations. During surgery, systolic arterial blood pressure, heart rate, and Bispectral index were comparable between SCI and control groups. However, end-tidal sevoflurane concentration was significantly smaller in the SCI (0.81%-1.06%) versus control (1.28%-1.31%) patients. In the control group, plasma norepinephrine and cortisol concentrations were significantly increased during and 1 h after surgery compared with awake baseline values. In the SCI group, the sympathoadrenal and cortisol responses were virtually abolished. We conclude that SCI reduces the anesthetic requirement by 20%-39% during surgery below the level of injury, in association with blunted sympathoadrenal and cortisol responses. |
Databáze: | OpenAIRE |
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