Epidural cooling for thoracoabdominal aortic surgery
Nakazawa, K.; Tohyama, S.; Masuda, A.; Kawatani, M.; Masuzawa, Y.; Makita, K.
Masui. Japanese Journal of Anesthesiology 51(8): 869-874
2002
ISSN/ISBN: 0021-4892 PMID: 12229135 Document Number: 540570
This report summarizes our experience with the use of epidural cooling for protecting spinal cord ischemic injury in patients receiving thoracoabdominal aortic surgery. Of 8 cases with thoracoabdominal aortic surgery, we used epidural cooling in 5 cases. Epidural cooling was performed through an epidural catheter placed at Th 11cntdot12 using chilled saline. Spinal cord temperature was maintained at approximately 28degreeC. None of the 5 cases had paraplegia or paraparesis whereas two of 3 cases without epidural cooling had permanent paraplegia. In one case with paraplegia, we could not detect any changes in spinal evoked potential until the end of graft anastomosis. We monitored motor evoked potential in the recent 2 cases. We believe that epidural cooling combined with motor evoked potential monitoring appears to be a satisfactory strategy for preventing ischemic spinal cord injury in thoracoabdominal aortic surgery.