Evaluation of usefulness of a point of care haemoglobin device in emergency neurosurgery

Abstract

The use of dexmedetomidine is in increasing trend particularly in patients with neurological disorders. A very few studies have focused on the cerebral haemodynamic effects of dexmedetomidine. This study is aimed to address this issue. Methods: Thirty patients without any intracranial pathology were included in this study. Middle cerebral artery flow velocity (FV) obtained from transcranial colour Doppler was used to assess the cerebral haemodynamic indices. Mean FV (mFV), pulsatility index (PI), cerebral vascular resistant index (CVRi), estimated cerebral perfusion pressure (eCPP) and zero flow pressure (ZFP) were calculated bilaterally at baseline and after infusion of injection dexmedetomidine 1 mcg/kg over 10 min. Results: Twenty-six patients completed the study protocol. After administration of loading dose (LD) of dexmedetomidine, mFV and eCPP values were significantly decreased in both hemisphere (P < 0.05); PI, CVRi and ZFP values showed significant increase (P < 0.05) after dexmedetomidine infusion. Conclusion: Increase in PI, CVRi and ZFP suggests that there is possibility of increase in distal CVR with LD of dexmedetomidine. Decrease in mFV and eCPP along with increase in CVR may lead to decrease in cerebral perfusion. This effect can be exaggerated in patients with pre-existing neurological illness. Further studies are needed to evaluate the effect of dexmedetomidine on various other pathological conditions involving brain such as traumatic brain injury and vascular malformations. ISNACC-S-27Cerebral oxygenation during electroconvulsive therapy Kaushik Theerth, Tanmay Jadhav, Sriganesh Kamath, Madhusudan Reddy Department of Neuroanaesthesia, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India Background: Near-infrared spectroscopy is a novel monitor to detect cerebral oxygenation (rSO 2 ). A very few studies have analysed the effect of electroconvulsive therapy (ECT) on rSO 2 . We hypothesised that atropine pre-medication related activation of systemic and cerebral haemodynamics will exacerbate ECT-induced increase in rSO 2 . This study aimed to assess the effect of atropine and no atropine pre-medication during ECT on rSO 2 and correlate this with haemodynamics and peripheral oxygen saturation. Methodology: Psychiatric patients aged between 18 and 60 years requiring modified ECT for their illness were included in this 6-month study. This was a randomised crossover trial, in which patients served as their own controls. For the second ECT session, patients were randomised to receive either 0.01 mg/kg atropine or no atropine preceding anaesthesia.