Summary
Changes in cerebrospinal fluid pressure, venous pressure, and arterial pressure induced by different concentrations of halothane were measured in ten elderly patients prior to the beginning of surgery. Cerebrospinal fluid and venous pressures were recorded by a water manometer and arterial pressure with a sphygmomanometer. Tidal volume, pH, and pCO2 were determined intermittently in order to prevent changes in respiratory physiology. The patients were intubated with a cuffed endotracheal tube and given 1/2 to 2 vol. per cent halothane, for periods of 15 minutes or longer, using a non-rebreathing system and a Fluotec vaporizer.
Two types of increase in cerebrospinal fluid pressure were noted. During endotracheal intubation, cerebrospinal fluid pressure rose sharply while venous pressure lagged behind and arterial pressure changed in a variable manner. During the period of undisturbed halothane anaesthesia, elevations of cerebrospinal fluid pressure corresponded with increases in the venous pressure, while arterial pressure decreased concomitantly. The magnitude of these changes was proportional to the concentration of halothane.
The implications of these findings on the administration of halothane anaesthesia during neurosurgical operations are discussed.
Résumé
Chez dix malades âgés, nous avons mesuré avant le début de la chirurgie les changements de la pression du liquide céphalorachidien, dp sang veineux et du sang artériel, qui surviennent au cours de l’ induction de l2019;anesthésie au fluothane à diverses concentrations. Les pressions du liquide céphalorachidien et du sang veineux ont été prises au moyen d’ un manomètre à l’ eau et la pression du sang artériel au moyen d’ un sphygmomanomètre. Pour éviter des changements daas la physiologie respiratoire, nous avons calculé, de façon intermittente, l’ air courant, le pH et 1e pCO2. Tous les malades étaient incubés avec un tube à ballonnet et, durant 15 minutes ou plus, recevaient du fluothane à des concentrations variant de 1/2 à 2 vol. per cent, en employant la vaporisateur fluotec et un système sans réinspiration.
Nous avons observé deux sortes d’ augmentation de pression du liquide céphalo-rachidien. Au cours de l’ intubation endotrachéale, la pression du liquide céphalorachidien s’ est élevée en flèche, la pression du sang veineux est demeurée basse et la pression du sang artériel a présenté des variantes. Au cours de la période de distribution de l’ agent anesthésique, les augmentations de la pression du liquide céphalorachidien correspondaient aux augmentations de la pression du sang veineux, pendant que la pression du sang artériel diminuait au même moment.
Article PDF
Similar content being viewed by others
References
Paine, E. G.;Boutwell, J. H.; &Soloff, L. A. Reliability of “Arterialized’ Venous Blood for Measuring Arterial pH and pCO2. Am. J. Med. Sci. 242: 431 (1961).
Wyke, B. D. Physiology of the Nervous System, chap. 5 in Evans, F. T., & Gray, T. C. General Anaesthesia’. London: Butterworth and Co. (1959).
Ryder, H. W.;Espey, F. F.;Kimbell, F. D.;Penka, E. J.;Rosenauer, A.;Podolsky, B.; &Evans, J. P. Influence of Changes in Cerebral Blood Flow on the perebrospinal Fluid Pressure. A.M.A. Arch. Neurol. & Psychiat. 68: 165 (1952).
LaFia, D. L:;Chase, H. F.; &Kilmore, M. A. Effects of Respiratory Obstruction during Craniotomy. J. Neurosurgery 17: 877 (1960).
Berman, A. J.;Halpern, A.;Shaftel, N.;Selman, D.;Shaftel, H. E.;Kohn, P. H.;Samuels, S. S.; &Birch, H. G. Cerebrovascular Dynamics of Bowel Function. Angiology 2:437 (1960).
Ryder, H. W.;Espey, F. F.;Kimbell, F. D.;Penka, E. J.;Rosenauer, A.;Podolsky, B.; &Evans, J. P. Effect of Changes in Systematic Venous Pressure on Cerebrospinal Fluid Pressure. A.M.A. Arch. Neurol. & Psychiat. 68: 175 (1952).
Hamilton, W, F.;Woodbury, R. A.; &Harper, H. T. Physiologic Relationships between Intrathoracic, Intraspinal and Arterial Pressures. J.A.M.A. 107: 853 (1936).
Small, H. S.;Weitzner, S. W.; &Nahas, G. G. Cerebrospinal Fluid Pressures during Hypercapnia and Hypoxia in Dogs. Am. J. Physiol. 198: 704 (1960)
Halldin, M., &Wahlin, A. Effect of Succinylcholine on the Intraspinal Fluid Pressure. Acta anaesth. scandinav. 3: 155 (1959).
Marx, G. F.;Zemaitis, M. T.; &Orkin, L. R. Cerebrospinal Fluid Pressures during Labor and Obstetrical Anesthesia. Anesthesiology 22: 348 (1961).
Woringer, E.;Brogly, G.; &Schneider, J. Etude de l’ action des anesthésiques généraux usuals sur la pression du liquide céphalo-rachidien, Anesthésie et Analgésie 8: 649 (1951).
Sondergard, W. Intracranial Pressure during General Anaesthesia. Danish Med. Bull. 8: 18 (1961).
Marx, G. F.; Oka, Y.; & Orkin, L. R. Cerebrospinal Fluid Pressures during Labor. Am. J. Obstet. & Gynecol. (in press).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Marx, G.F., Andrews, I.C. & Orkin, L.R. Cerebrospinal fluid pressures during halothane anaesthesia. Can. Anaes. Soc. J. 9, 239–245 (1962). https://doi.org/10.1007/BF03023865
Issue Date:
DOI: https://doi.org/10.1007/BF03023865