Intraoperative Development of Tension Pneumocephalus in a Patient Undergoing Repair of a Cranial-Dural Defect Under Nitrous Oxide Anesthesia.

Mansher Singh, Viren S Vasudeva, Arturo J Rios Diaz, Ian F Dunn, Edward J Caterson
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引用次数: 11

Abstract

Rapid buildup of gas within the cranial vault can result in a life-threatening condition known as "tension pneumocephalus," necessitating immediate surgical intervention. Nitrous oxide (N2O), a commonly used inhaled anesthetic, is associated with the development of tension pneumocephalus and its role in neurosurgical procedures has been debated in the literature. We present a case of tension pneumocephalus with preexisting pneumocephalus secondary to the usage of N2O as an inhaled anesthetic. Included is a literature review of studies discussing the role of N2O in the development of tension pneumocephalus. N2O is associated with tension pneumocephalus especially in the setting of preexisting pneumocephalus. Tension pneumocephalus can manifest as Cushing response and immediate decompression is life-saving. Nitrous oxide should be used cautiously in neurosurgical procedures, especially with preexisting pneumocephalus.

Abstract Image

一氧化二氮麻醉下颅硬膜缺损修复术中张力性脑气的发生。
颅顶内气体的迅速积聚可导致危及生命的“张力性脑气”,需要立即进行手术干预。一氧化二氮(N2O)是一种常用的吸入麻醉剂,与张力性气颅的发展有关,其在神经外科手术中的作用在文献中一直存在争议。我们提出一个病例张力性气头与先前存在的气头继发使用N2O作为吸入麻醉剂。包括一篇文献综述,讨论了N2O在张力性气脑发展中的作用。N2O与张力性气头有关,特别是在先前存在的气头的情况下。张力性气头可表现为库欣反应,立即减压可挽救生命。在神经外科手术中应谨慎使用一氧化二氮,特别是对先前存在的气脑。
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