Thiopental Loading During Controlled Hypotension for Intracranial Aneurysm Surgery |
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Authors: | A. O. Bendtsen,,G. E. Cold,M.D.,J. Astrup, J. Rosenø rn |
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Affiliation: | Department of Anaesthesiology and Neurosurgery, Hvidovre Hospital, Hvidovre, Denmark |
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Abstract: | In this study we report our clinical experience with supplementary thiopental loading, based on 30 patients undergoing surgery for intracranial aneurysm after a recent episode of subarachnoid haemorrhage. As standard procedure we used pentobarbitone induction, pancuronium relaxation, endotracheal intubation, maintenance with halothane 0.5%, N2O 66% in oxygen, fentanyl, and moderate hypocapnia. A thiopental load of up to 20 mg.kg-1 was supplied while the aneurysm was approached. Satisfactory and well-controlled hypotension was obtained in five cases after thiopental alone, and after thiopental and sodium nitroprusside (SNP) ( ± s.d.) 1.3 ± 0.9 μg-kg-1-min-1 in the remaining 25 patients. No ECG sign of myocardial ischaemia was observed. One disadvantage was a prolonged recovery period, which in some cases necessitated controlled ventilation for some hours. We conclude that thiopental loading can be used safely as a supplement to neuroanaesthesia for aneurysm surgery. |
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Keywords: | Aneurysm controlled hypotension neuroanaesthesia thiopental load |
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