Abstract
The beneficial effect of high doses of barbiturates in cerebral ischaemia is well documented in experimental animals [1,2,3,4], Their action is dose-related and early administration after an ischaemic episode is clearly crucial. The best results might therefore be expected if barbiturate therapy precedes the ischaemic episode. There are now a few clinical reports of barbiturate therapy instituted after resuscitation from cardiac arrest [5], in head injury patients [6], and in metabolic coma [7]. Prompt administration under these conditions is often difficult and the clinical results difficult to interpret.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Smith AL, Hoff JT, Nielsen SL, Larson CP (1974) Barbiturate Protection in acute focal cerebral ischaemia. Stroke 5: 1
Safar P, Bleyaert A, Nemoto EM, Moossy J, Snyder JV (1978) Resuscitation after global brain ischaemia-anoxia. Critical care Medicine 6: 215
Smith AL (1977) Barbiturate protection in cerebral hypoxia. Anesthesiology 47: 285
Belopavlovic M, Buchthal A (1980) Barbiturate therapy in cerebral ischaemia - a review. Anaesthesia, in press.
Brievik H, Safar P, Sands P, Fabritius R, Lind B, Lust P, Mullie A, Orr M, Renck H, Snyder JV (1978) Clinical feasibility trials of barbiturate therapy after cardiac arrest. Critical care Medicine 6: 228
Marshall LF, Smith RW, Shapiro HM (1979) The outcome with aggressive treatment in severe head injuries. Part I, The significance of intracranial pressure monitoring. J Neurosurgery 50:20. Part II,Acute and chronic barbiturate administration in the management of head injury. J Neurosurgery 50: 26
Marshall LF, Shapiro HM, Rauscher A, Kaufman N (1978) Pentobarbital therapy for intracranial hypertension in metabolic coma. Critical care Medicine 6: 1
Lafferty JJ, Keykhah MM, Shapiro HM, Van Horn K, Behar MG (1978) Cerebral hypometabolism obtained with deep pentobarbital anaesthesia and hypothermia (30°) Anesthesiology 49: 159
Hagerdal M, Welsh FA, Keykhah MM, Perez E, Harp JR (1978) Protective effects of combinations of hypothermia and barbiturates in cerebral hypoxia in the rat. Anesthesiology 49: 165
Hagerdal M, Keykhah M, Perez E, Harp JR (1979) Additive effects of hypothermia and phenobarbital upon cerebral oxygen consumption in the rat. Acta Anaes Scand 23: 89
Maynard D, Prior PF, Scott DF (1968) Device for continuous monitoring of cerebral activity in resuscitated patients. Brit Med J 4: 545
Rivano C, Rossi GF, Zattoni J (1972) Variations of intraventricular and local brain pressures during neurosurgical procedures. In: Brock and Dietz (eds) Rivano C, Rossi GF, Zattoni J I. Springer Verlag
Albin MS, Bunegin L, Helsel P, Marlin A, Babinski MM (1979) Intracranial pressure and cerebral blood flow responses to experimental brain retraction pressure. In: Fourth Symposium on intracranial Pressure, Williamsburg, 1979
Miller JD, Stanek AE, Langfitt TW (1973) Cerebral blood flow regulation during experimental brain compression. J Neurosurgery 39: 186
Forster A, Van Horn K, Marshall LF, Shapiro HM (1978) Anaesthetic effects on blood brain barrier function during acute arterial hypertension. Anesthesiology 49: 26
Häggendal E, Johansson (1979) On the pathophysiology of the increased cerebrovascular permeability in acute arterial hypertension in cats. Acta Neurol Scand 48: 265
Schutta HE, Kassess NF, Langfitt TW (1968) Brain swelling produced by injury and aggravated by arterial hypertension. Brain 91: 281
Michenfelder JD (1974) The interdependency of cerebral functional and metabolic effects following massive doses of thiopental in the dog. Anesthesiology 41: 231
Hoff JT, Smith AL, Hankinson HL, Nielsen SL (1975) Barbiturate protection from cerebral infarction in primates. Stroke 6: 28
Michenfelder JD, Theye RA (1975) In vivo toxic effects of halothane on canine metabolic pathways. Am J Physiol 229: 1050
Crane PD, Braun LD, Cornford EM, Cremer JE, Glass JM, Oldendorf WH (1978) Dose dependent reduction of glucose utilisation by pentobarbital in rat brain. Stroke 9: 12
Simeone FA, Frazer G, Lawner P (1979) Ischaemic brain edema: Comparative effects of barbiturates and hypothermia. Stroke 10: 8
Belopavlovic M, Buchthal A (1980) Barbiturate therapy in the management of cerebral ischaemia. Anaesthesia, in press
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1981 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Belopavlovic, M., Buchthal, A. (1981). Combined Hypothermia and Barbiturate Therapy for Cerebrovascular Surgery. In: Haid, B.C., Mitterschiffthaler, G. (eds) Zentraleuropäischer Anaesthesiekongreβ. Anaesthesiologie und Intensivmedizin / Anaesthesiology and Intensive Care Medicine, vol 139. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-68188-2_28
Download citation
DOI: https://doi.org/10.1007/978-3-642-68188-2_28
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-10942-6
Online ISBN: 978-3-642-68188-2
eBook Packages: Springer Book Archive