[Epidural cooling for thoracoabdominal aortic surgery].
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 11 x 12 using chilled saline. Spinal cord temperature was maintained at approximately 28 degrees C. 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.
Nakazawa
Koichi
K
Department of Anesthesiology and Critical Care Medicine, Tokyo Medical and Dental University, Tokyo 113-8519.
Tohyama
Satoshi
S
Masuda
Akio
A
Kawatani
Masako
M
Masuzawa
Yoshie
Y
Makita
Koshi
K
D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D004824:Epidural Space; D019054:Evoked Potentials, Motor; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007431:Intraoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D016343:Monitoring, Intraoperative; D010264:Paraplegia / Q000517:prevention & control; D012189:Retrospective Studies; D020760:Spinal Cord Ischemia / Q000175:diagnosis / Q000517:prevention & control