Induced Hypotension and Cerebral
Protection
· Vascular cases may require periods
of hypotension to allow clipping of an aneurysm or to decrease blood loss from
an active AVM during resection
- Agents
typically used are nitroglycerine and nipride
- Proper
protection of cerebral cortex during the period of induced hypotension is
crucial to prevent infarction
- Strategies
for cortical protection include hypothermia and the use of pentobarbital
- Both act
to decrease cerebral metabolic activity and O2 metabolic
requirements
- With
pentobarbital, goal is to place patient into EEG burst suppression