Circulatory changes in the sitting position during neurosurgical anaesthesia (NLA)
Huse, K.; Wiecken, H.
Der Anaesthesist 28(12): 557-563
1979
ISSN/ISBN: 0003-2417 PMID: 539650 Document Number: 146378
In 23 neurosurgical patients the hemodynamic effects of neuroleptanesthesia in the supine (13 patients) and upright position (10 patients) were studied. The patients in the upright position demonstrated an increase of the mean arterial pressure of 19% and the total peripheral resistance [TPR] of 45%, and simultaneously a decreased stroke index [SI] of 20% and the cardiac index [CI] of 16%. The stability of the circulation was preserved due to the increase of heart rate (to 90 .+-. 17 beats/min) and TPR. In spite of almost identical average total doses of fentanyl in both groups (4.72 .+-. 2.2 mcg/kg per h), (supine position) and 4.97 .+-. 2.23 mcg/kg per h, (sitting position), only the patient group in the supine position demonstrated a decrease of pulse rate of 36% to 65 .+-. 20 beats/min with a decline of the CI of 33% and unchanged SI. During neuroleptanesthesia in the upright position the baroreceptor-activity and the catecholamine secretion is apparently not markedly reduced and circulatory stability obtained. Neuroleptanesthesia is the method of choice for neurosurgical operations in the upright position.