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The effects of composition of subarachnoid gas space and anesthetic gas mixture on cerebrospinal fluid pressure changes during cisternography for transsphenoidal craniectomy

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Abstract

The effects of gas composition in the subarachnoid space (injection of air or N2O) and in an anesthetic gas mixture (inhalation with or without N2O) on cerebrospinal fluid pressure were studied in 22 patients with pneumocisternography for transsphenoidal craniectomy. N2O (66%) anesthesia for 10 min increased cerebrospinal fluid pressure by up to 150% in 7 patients who were intrathecally injected with air. Withdrawal of N20 from the anesthetic gas mixture for sixty minutes reduced cerebrospinal fluid pressure to the initial pressure. A second N2O administration to the anesthetic gas mixture did not elevate cerebrospinal fluid pressure by as much as the first N20 administration. In 7 patients receiving subarachnoid air injection, replacing 66% N2O with 66% nitrogen prevented the change in cerebrospinal fluid pressure throughout the operation. In 8 patients N20 anesthesia and N20 intrathecal injection failed to eliminate the rise in cerebrospinal fluid pressure in 8 patients. Withdrawal of N20 from the anesthetic gas mixture for 60 min is recommended to prevent an extreme increase in cerebrospinal fluid pressure during pneumocisternography.

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Authors and Affiliations

  1. Department Anesthesia, Saiseikai-Tbndabayashi Hospital, 1-3-36, Kouyoudai, Tondabayashi, 584, Osaka, Japan

    Shiro Oku

  2. Department of Anesthesiology, School of Medicine, Kinki University Osaka, Japan

    Katsutoshi Wakita, Motoko Hunasaka & Keita Suekane

  3. Department of Neurosurgery, School of Medicine, Kinki University Osaka, Japa

    Yuu Watanabe

Authors
  1. Shiro Oku
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  2. Katsutoshi Wakita
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  3. Motoko Hunasaka
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  4. Keita Suekane
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  5. Yuu Watanabe
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Oku, S., Wakita, K., Hunasaka, M. et al. The effects of composition of subarachnoid gas space and anesthetic gas mixture on cerebrospinal fluid pressure changes during cisternography for transsphenoidal craniectomy. J Anesth 5, 221–227 (1991). https://doi.org/10.1007/s0054010050221

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  • DOI: https://doi.org/10.1007/s0054010050221

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