Effect of Reverse Trendelenburg Position on Subdural Intracranial Pressure and Cerebral Haemodynamics During General Anaesthesia for Craniotomy in Patients with Supratentorial Cerebral Tumours
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The effects of head and trunk elevation on cerebral haemodynamics have been investigated in intensive care patients. In most of these studies, head and trunk elevation resulted in decreased ICP. The effect of head elevation on ICP and cerebral haemodynamics during general anaesthesia for craniotomy in patients with cerebral tumours has only been sparsely investigated. In this chapter data on four studies concerning the reverse Trendelenburg position in patients with significant space-occupying lesions as well as patients with cerebral aneurysms are presented and discussed. The ICP-lowering effect of 10 degrees reverse Trendelenburg position in two groups of prone- and supine-positioned patients are presented. The optimal reverse position is disclosed and the influence of the anaesthetic regime discussed.
KeywordsIntracranial Pressure Neutral Position Cerebral Perfusion Pressure Cerebral Tumour Cerebellar Tumour
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