Cardiovascular disturbances caused by extradural negative pressure drainage systems after intracranial surgery

• Published in: British journal of anaesthesia : BJA Vol. 80; no. 5; pp. 599 - 601
• Main Authors: Hernández-Palazón, J, Tortosa, J A, Sánchez-Bautista, S, Martínez-Lage, J F, Pérez-Flores, D
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.1998; Oxford University Press; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Biological and medical sciences; Blood Pressure - physiology; Brain - surgery; Cerebral Hemorrhage - prevention & control; Female; Heart Rate - physiology; Hematoma - prevention & control; Hemodynamics - physiology; Humans; Intracranial Pressure - physiology; Male; Medical sciences; Middle Aged; Neurosurgery; Postoperative Care - adverse effects; Postoperative Complications - prevention & control; Prospective Studies; Skull, brain, vascular surgery; Suction - adverse effects; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Human; Nervous system diseases; Craniocerebral; Surgical drainage; Cardiovascular disease; Intracranial pressure; Extradural; Heart rate; Surgery; Central nervous system disease; Complication; Blood pressure; Hemodynamics; Cerebrovascular disease
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/80.5.599

Extradural drainage systems connected to a vacuum device for preventing postoperative haematoma formation are often used in neurosurgical practice. Cardiovascular complications, including bradycardia or low arterial pressure caused by intracranial hypotension, have been described associated with their use. We have investigated the relationship between the negative pressure applied to extradural drainage systems and intracranial pressure (ICP), and analysed the effects of negative pressure of the drains on systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressures and on heart rate (HR). We studied prospectively 15 patients undergoing neurosurgery for supratentorial tumours or aneurysms. Transient decreases in ICP (P < 0.001) and HR (P < 0.001), with no clinical effects, were observed after connecting the vacuum device to the drain. There were no significant changes in SAP, DAP or MAP.