[The significance of concurrent vertebrobasilar insufficiency in postanesthesia recovery].
A study of 149 patients was carried out, who had cervical osteochondrosis, by using the stage-based narcosis and general intravenous anesthesia. The parameters of the peripheral velocity of the bloodstream in the direct brain venous sine were examined by transcranial dopplerography. Preoperatively, the patients were shared between 3 groups with due respect to clinical and neurological symptoms as well as to X-ray-registered changes in the cervical spine. While evaluating the intracranial pressure, the cerebral hemodynamics was examined by ophthalmodynamometry procedures (diastolic pressure in the retinal central vein). The anatomotopographic peculiarities of the cervical spine, and in particular, of the spinal artery, vein and sympathetic nerve passage, as observed in the lateral vertebral processes in cases of spine osteochondrosis, aggravate the strangulation and blood circulation disturbances in the basilar and vertebral regions with respect to changes of the head position. Trachea incubation (head extended with anesthetic management), made in patients with the pronounced cervical osteochondrosis (group III), slowed down the peripheral blood flow into the direct brain venous sine; it also caused a higher intracranial pressure versus the parameters observed in the basilar and vertebral deficiency, as well as hemodynamics instability resulting in a late awakening after anesthetic management.
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Kostylev
D000328:Adult; D000762:Anesthesia Recovery Period; D001921:Brain / Q000098:blood supply; D002574:Cervical Vertebrae / Q000098:blood supply / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D010007:Osteochondritis / Q000601:surgery; D011859:Radiography; D014715:Vertebrobasilar Insufficiency / Q000209:etiology* / Q000503:physiopathology