Be careful to avoid hemodynamic disturbances in craniosynostosis surgery

While the surgeons were putting the large gauge pad on the exposed brain, we observed a sudden decrease of heart rate from 118/min to 44/min and increase in invasive BP from 92/45 mmHg to 118/63 mmHg. [1],[2] The different causes of hemodynamic disturbances in a craniosynostosis surgery can be blood...

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Bibliographic Details
Published in:	Saudi journal of anaesthesia Vol. 14; no. 3; pp. 420 - 421
Main Authors:	Prasad, Chandrakant, Dube, Surya, Chaturvedi, Arvind
Format:	Journal Article
Language:	English
Published:	Riyadh Wolters Kluwer India Pvt. Ltd 01-07-2020 Medknow Publications and Media Pvt. Ltd Medknow Publications & Media Pvt. Ltd Wolters Kluwer - Medknow Wolters Kluwer Medknow Publications
Subjects:	Cardiac arrhythmia Heart rate Hypertension Letters to Editor Surgeons Surgery
Online Access:	Get full text
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Summary:	While the surgeons were putting the large gauge pad on the exposed brain, we observed a sudden decrease of heart rate from 118/min to 44/min and increase in invasive BP from 92/45 mmHg to 118/63 mmHg. [1],[2] The different causes of hemodynamic disturbances in a craniosynostosis surgery can be blood loss, venous air embolism (VAE), anaphylactic reaction, or a trigeminocardiac reflex (TCR). No apparent blood loss during the event and sudden onset of bradycardia with hypertension that resolved upon removal of direct pressure on brain went more in favor of a diagnosis of either TCR or a sudden increase in ICP causing Cushing's response in our case.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1658-354X 0975-3125
DOI:	10.4103/sja.SJA_148_20