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Anesthetic considerations for patients with acute cervical spinal cord injury 被引量:3

Anesthetic considerations for patients with acute cervical spinal cord injury
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摘要 Anesthesiologists work to prevent or minimize secondary injury of the nervous system and improve the outcome of medical procedures.To this end,anesthesiologists must have a thorough understanding of pathophysiology and optimize their skills and equipment to make an anesthesia plan.Anesthesiologists should conduct careful physical examinations of patients and consider neuroprotection at preoperative interviews,consider cervical spinal cord movement and compression during airway management,and suggest awake fiberoptic bronchoscope intubation for stable patients and direct laryngoscopy with manual in-line immobilization in emergency situations.During induction,anesthesiologists should avoid hypotension and depolarizing muscle relaxants.Mean artery pressure should be maintained within 85–90 mmHg(1 mmHg = 0.133 kPa; vasoactive drug selection and fluid management).Normal arterial carbon dioxide pressure and normal blood glucose levels should be maintained.Intraoperative neurophysiological monitoring is a useful option.Anesthesiologists should be attentive to postoperative respiratory insufficiency(carefully considering postoperative extubation),thrombus,and infection.In conclusion,anesthesiologists should carefully plan the treatment of patients with acute cervical spinal cord injuries to protect the nervous system and improve patient outcome. Anesthesiologists work to prevent or minimize secondary injury of the nervous system and improve the outcome of medical procedures.To this end,anesthesiologists must have a thorough understanding of pathophysiology and optimize their skills and equipment to make an anesthesia plan.Anesthesiologists should conduct careful physical examinations of patients and consider neuroprotection at preoperative interviews,consider cervical spinal cord movement and compression during airway management,and suggest awake fiberoptic bronchoscope intubation for stable patients and direct laryngoscopy with manual in-line immobilization in emergency situations.During induction,anesthesiologists should avoid hypotension and depolarizing muscle relaxants.Mean artery pressure should be maintained within 85–90 mmHg(1 mmHg = 0.133 kPa; vasoactive drug selection and fluid management).Normal arterial carbon dioxide pressure and normal blood glucose levels should be maintained.Intraoperative neurophysiological monitoring is a useful option.Anesthesiologists should be attentive to postoperative respiratory insufficiency(carefully considering postoperative extubation),thrombus,and infection.In conclusion,anesthesiologists should carefully plan the treatment of patients with acute cervical spinal cord injuries to protect the nervous system and improve patient outcome.
出处 《Neural Regeneration Research》 SCIE CAS CSCD 2017年第3期499-504,共6页 中国神经再生研究(英文版)
关键词 nerve regeneration cervical spine injury cervical spinal cord injury spinal cord injury ANESTHESIA airway management INDUCTION INTUBATION NEUROPROTECTION neurophysiological monitoring NEUROPROTECTION neural regeneration nerve regeneration cervical spine injury cervical spinal cord injury spinal cord injury anesthesia airway management induction intubation neuroprotection neurophysiological monitoring neuroprotection neural regeneration
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