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The selection of anesthetic methods for labor and delivery in individuals with elevated intracranial pressure relies on careful consideration of the risks and benefits. While neuraxial analgesia and anesthesia are favored for healthy individuals, they might not be suitable for individuals with intracranial lesions or a heightened risk of bleeding. Neuraxial block in post-stroke patients raises a concerning question about its safety due to the risk of herniation. The risk of perioperative major vascular events and mortality between general anesthesia and regional anesthesia in post-stroke patients is comparable. However, the neuraxial block shows benefits regarding airway manipulation and lower risk of thromboembolism. A successful and safe neuraxial anesthesia in a pregnant patient with a history of hemorrhagic stroke was presented in this case report.

Copyright of Agri: Journal of the Turkish Society of Algology / Türk Algoloji (Ağrı) Derneği'nin Yayın Organıdır is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç: Bu retrospektif çalışmada hastanemizde intrakranial kitle cerrahisi uygulanan hastalardaki anestezi deneyimimizin değerlendirilmesi ve perioperatif yönetimin literatür eşliğinde tartışılması amaçlanmıştır.Gereç ve Yöntem: 2015-2016 tarihleri arasında intrakranial kitle cerrahisi geçiren yaşları 3 ile 78 arasında ASA risk sınıflaması I-III olan 112 hasta retrospektif olarak değerlendirildi. Veriler için anestezi kayıt formları, hasta dosyaları ve hastane bilgisayar sistemi kullanıldı. Hastaların demografik özellikleri, anestezi yönetimi ve postoperatif bilgileri kaydedildi.Bulgular: Hastaların yaş aralığı 3 ile 78 arasında değiştiği ve %57.1’nin erkek olduğu tespit edildi. 98 (%87.5) hastanın kitlesi supratentorial bölgede iken 14 (%12.5)’nin infratentorial bölgede lokalize olduğu saptandı. Ortalama operasyon süresi 184 dakika, ortalama yoğun bakımda kalış süresi 3 gün, hastanede kalış süresi 7 gündür. İntroperatif dönemde görülen komplikasyonlar arasında taşikardi (%5.4), bradikardi (%3.6), hipertansiyon (%3.6) ve hipotansiyon (%1.8) yer almaktadır. Takiplerde 13 (%11.6) hastanın tekrar operasyona alındı. Preoperatif ve postoperatif dönemde ölüm ile karşılaşılmadı Sonuç: İntrakranial kitle cerrahisi için nöroaanestezi uygulamalarında çeşitli anestezi teknikleri başarıyla kullanılabilir. İnvaziv monitorizasyon, sıkı hemodinami ve kan gazı takibi ile olası komplikasyonlar erken fark edilerek mortalite ve morbidite azaltılabilir.

Objective: The aim of the present study is to compare the effect of 20% mannitol and 3% NaCl on blood coagulation in vitro using rotational thromboelastometry (ROTEM). Methods: Twenty-millilitre blood samples were obtained from 15 volunteers. In each group, 2 mL blood samples were collected into both polypropylene tubes and EDTA tubes for ROTEM and hemogram analysis. After sampling, blood samples were diluted with test solutions. Group C (control): Only blood, Group M (mannitol): 7% vol 20% mannitol concentration in the blood, Group hypertonic saline (HS): 7% vol 3% hypertonic saline (NaCl) in the blood, Group M/H (mannitol and hydroxyethyl starch solutions [HES]): 6% vol 20% mannitol concentration and 8% vol HES in the blood and Group HS/H (hypertonic saline and HES): 6% vol 3% hypertonic saline concentration and 8% vol HES in the blood. The following thromboelastometric parameters were measured automatically: clotting time (CT) and clot formation time (CFT) with intrinsic activation by tissue factor (InTEM), CT, CFT and maximum clot firmness (MCF) with extrinsic activation by tissue factor (ExTEM) and MCF with FibTEM. Results: The ExTEM CT value was found to be significantly longer in the M/H group than in the controls. The ExTEM CFT median and percentile values were: group C: 85 s (70-95 s), group M: 115 s (94-128 s), group HS: 102 s (84-114 s), group M/H: 128 s (110-144 s) and group HS/H: 118 s (107-132 s). In all the groups, FibTEM MCF values were significantly lower than the control and also there was a significant difference between groups M and HS according to FibTEM MCF values. Conclusion: Whole-blood coagulation disorder induced by these solutions is mainly dependent on fibrinogen and fibrin interaction. However, 3% HS has much less negative effect on coagulation. [ABSTRACT FROM AUTHOR]

Copyright of Cukurova Medical Journal / Çukurova Üniversitesi Tip Fakültesi Dergisi is the property of Cukurova University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The study aimed to carry out a retrospective analysis of 1709 patients anaesthetized for intracranial mass surgery between 2000 and 2010. Methods: Data were mainly obtained from preoperative and intraoperative anaesthetic record forms. To obtain data, we used the patients’ records and hospital medical information system. Results: It was observed that 1103 patients (64.5%) had one or more accompanying systemic disease. Thiopental was the most frequently used induction agent and the most frequently used muscle relaxant agent was cisatracurium and propofol+remifentanyl were most frequently used for maintenance of anaethesia. The mean Glasgow Coma Scale (GCS) of 1709 patients was 14.27±1.80 and the mean postoperative GCS was 14.02±1.42 in 1495 patients. A statistically significant difference was observed between preoperative and postoperative means of GCS (p<0.05). In the study, the mean duration of anaesthesia was 217.57±91.67 min. The duration of anaesthesia in patients developing intraoperative complications was longer than those who did not (p<0.05). In the study, it was determined that 371 patients required intensive care and 299 patient lost their lives during intraoperative or postoperative periods. Conclusion: It is concluded that the rate of intraoperative complications has decreased in patients operated with the diagnosis of intracranial mass over the past 11 years and that the repetition of retrospective studies periodically would contribute to development of the anaesthesiology. [ABSTRACT FROM AUTHOR]