title: [Anesthetic management of patients undergoing irrigation and drainage of chronic subdural hematoma--retrospective analysis of analgesia and sedation under locoregional anesthesia].
abstract: We retrospectively investigated the relationship between intraoperative hemodynamic variability and variables including patient background, anesthetic profile, and operative profile in 108 patients undergoing irrigation and drainage of chronic subdural hematoma under locoregional anesthesia. Patients were divided into two groups according to the degree of changes in mean arterial blood pressure (MAP) and heart rate (HR) during operation. Group A (n = 66) had MAP and HR changes < 20%, and Group B (n = 42) had MAP or HR changes > or = 20% of preoperative baseline values. Age was significantly higher in group B than Group A (mean +/- SD; 70 +/- 12 vs. 62 +/- 14 years, P < 0.01). In respect to additional anesthetic agents used (none; no additional anesthetic agents, enough; pentazocine > or = 0.3 mg.kg-1 and droperidol > or = 0.05 mg.kg-1, pentazocine > or = 0.5 mg.kg-1 or droperidol > or = 0.15 mg.kg-1, little; less than "enough"), ratio of "little" administered in Group B was significantly higher than that in Group A (64.3% vs. 37.9%, P < 0.05). These findings suggest that intraoperative hemodynamic variability under locoregional anesthesia in patients with chronic subdural hematoma is associated with age and insufficient use of hypnotic and/or analgesic agents.
authors.affiliation: Department of Anesthesiology, Osaka Neurological Institute, Toyonaka.
authors.forename: S
authors.initials: S
authors.lastname: Inoue
authors.forename: H
authors.initials: H
authors.lastname: Ninaga
authors.forename: M
authors.initials: M
authors.lastname: Kawaguchi
authors.forename: H
authors.initials: H
authors.lastname: Furuya
authors.forename: H
authors.initials: H
authors.lastname: Touho
authors.forename: J
authors.initials: J
authors.lastname: Karasawa
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000367:Age Factors; D000368:Aged; D000698:Analgesia; D000765:Anesthesia, Conduction; D000772:Anesthesia, Local; D002908:Chronic Disease; D004322:Drainage; D004329:Droperidol / Q000008:administration & dosage; D006408:Hematoma, Subdural / Q000628:therapy*; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D010423:Pentazocine / Q000008:administration & dosage; D012189:Retrospective Studies; D007507:Therapeutic Irrigation
chemical_list: D000759:Adjuvants, Anesthesia; D004329:Droperidol; D010423:Pentazocine