Abstract
This study determined the cardiovascular effects of percutaneous radiofrequency coagulation of the Gasserian ganglion, performed under neuroleptanaigesia and intermittent ultrashon-acting barbiturate anaesthesia. Twelve ASA physical status class II patients were studied. Highly significant increases in mean heart rate and arterial blood pressure followed the insertion of the cannula electrode into the Gasserian ganglion (p < 0.001). In six randomly assigned patients severe tachycardia and hypertension also accompanied the progress of the thermal lesion (p < 0.0001). Three patients developed premature ventricular contractions, and two developed significant ST segment depression. Intravenous nitroglycerin, used during current generation, successfully controlled the hypertensive response in the other six patients. In percutaneous thermocoagulation of the Gasserian ganglion the patient’s co-operation is essential. In addition to providing suitable operating conditions for both surgeons and patient, we should also be able to maintain normal and stable cardiovascular haemodynamics. Intravenous nitroglycerin used as an adjunct to light general anaesthesia safely maintained intraoperative normotension. It is also suggested that patients with coronary artery disease be adequately monitored and protected during the procedure.
Résumé
La thermocoagulation du ganglion de Gasser par une approche percutanee est faite avec l’appoint a’une technique de neuroleptanalgésie et Vutilisation de barbituriques à action ultra-courte. Les effets de la chirurgie et de l’anesthésie sur les pararnètres cardiovasculaires ont été relevés chez douze patients classés en catégoric ASA II. Une augmentation marquee de lafréquence cardiaque et de la pression arterielle systémique a ete observée au moment de l’insertion de l’electrode dans ie ganglion de Gasser (p < 0.001). Six patients ont presente une tachycardie et une hypertension severe au cours de la coagulation (p < 0.0001); chez trots patients des extrasystoles ventriculaires sont apparues, tandis qu’on notait une depression significative du segment ST chez deux patients. La nitroglycérine par voie intraveineuse a ite utilisee avec succès chez six autres patients; cette drogue a permis de contrôler la réponse hypertensive lors de la coagulation, La coopération et la participation du patient sont indispensables au succes de la procédure chirurgicale et une technique anesthésique de très courte durée assure les meilleures conditions de travail au chirurgien. Par ailleurs, comme beaucoup de ces patients sont gés et hypothéquées, il faut veiller d ne pas aggresser la fonction hémodynamique et à maintenir tension artérielle et fréquence cardiaque dans des limites normales. La nitroglycérine intraveineuse combinée à une anesthésie légère protege le patient en empêchant les flucluations cardiovasculaires marquées. Quelle que soil la technique utilisée, il est essentiel de surveiller de très près les patients lors de cette procédure chirurgicale.
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Abou-Madi, M., Trop, D., Morin, L. et al. Anaesthetic considerations in percutaneous radiofrequency coagulation of the gasserian ganglion. Can Anaesth Soc J 31, 255–262 (1984). https://doi.org/10.1007/BF03007885
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DOI: https://doi.org/10.1007/BF03007885