Some aspects of systemic and cerebral hemodynamics with intrahospital transport in patients after clipping aneurysm of the brain

Abstract

Goal. Evaluate cerebral hemodynamics in the patient after clipping of saccular aneurysms of the brain during nosocomial transportation, in the early postoperative period. Material and methods. A study was conducted in 86 patients divided into four groups, where the first group of patients was transported without additional sedation, the second - with additional sedation with solutions of morphine hydrochloride 1 % - 1.0 and a bit of diazepam 0.5 % - 2.0, in the third group, patients were sedated with propofol solution at a dose of 1 mg/kg in the 3rd group, and a solution of sodium thiopental at a dose of 4 mg/kg was administered in the 4th group for sedation prior to transport. Results. In the first group, a significant increase in the average velocity of blood flow through the cerebral vessels was found to be 23.5 % on the side of operational combat. The use of any of the three proposed schemes for additional sedation of a significant level of salary increase, but in the 3 rd and 4 th groups the blood pressure is statistically significantly lower. Conclusion. An increase in the indices of cerebral angiospasm during intra-hospital transportation was revealed. Justification of the use of additional sedation, transported with the use of artificial ventilation. It has been proved that during sedation and analgesia morphine and diazepammental shifts of systemic hemodynamics do not occur, however, the increase in the indices of cerebral angiospasm is significantly lower than in the first group of patients.