COTTRELL AND YOUNG`S NEUROANESTHESIA

COTTRELL AND YOUNG’S
NEUROANESTHESIA
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
This page intentionally left blank
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
COTTRELL AND YOUNG’S
NEUROANESTHESIA
FIFTH EDITION
James E. Cottrell, MD, FRCA
Distinguished Service Professor and Chairman
Department of Anesthesiology
State University of New York Downstate College of Medicine
Brooklyn, New York
William L. Young, MD
James P. Livingston Professor and Vice-Chair
Department of Anesthesia and Perioperative Care
Professor of Neurological Surgery and Neurology
University of California, San Francisco School of Medicine
Director, UCSF Center for Cerebrovascular Research
San Francisco, California
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
COTTRELL AND YOUNG’S NEUROANESTHESIA
ISBN: 978-0-323-05908-4
Copyright © 2010, 2001, 1994, 1986, 1980 by Mosby, Inc., an affiliate of Elsevier Inc.
All rights reserved. No part of this publication may be reproduced or transmitted in any form
or by any means, electronic or mechanical, including photocopying, recording, or any information storage and
retrieval system, without permission in writing from the publisher.
Notice
Knowledge and best practice in this field are constantly changing. As new research and e­ xperience broaden
our knowledge, changes in practice, treatment, and drug therapy may become necessary or appropriate.
Readers are advised to check the most current information provided (i) on procedures featured or (ii) by
the manufacturer of each product to be administered to verify the recommended dose or formula, the
method and duration of administration, and contraindications. It is the responsibility of the practitioner,
relying on his or her own experience and knowledge of the patient, to make diagnoses, to determine dosages
and the best treatment for each individual patient, and to take all appropriate safety precautions. To the
fullest extent of the law, neither the Publisher nor the Authors assume any liability for any injury and /or
damage to persons or property arising out of or related to any use of the material contained in this book.
The Publisher
Library of Congress Cataloging-in-Publication Data
Cottrell’s neuroanesthesia / [edited by] James E. Cottrell, William L.
Young. — 5th ed.
p. ; cm.
Rev. ed. of: Anesthesia and neurosurgery / [edited by] James E.
Cottrell, David S. Smith. 4th ed. c2001.
Includes bibliographical references and index.
ISBN 978-0-323-05908-4
1. Nervous system—Surgery. 2. Anesthesia in neurology. I. Cottrell,
James E. II. Young, William L. III. Anesthesia and neurosurgery. IV.
Title: Neuroanesthesia.
[DNLM: 1. Anesthesia. 2. Neurosurgical Procedures. WO 200 C851
2010]
RD593.A5 2010
617.9’6748—dc22
2009039629
Executive Publisher: Natasha Andjelkovic
Editorial Assistant: Bradley McIlwain
Publishing Services Manager: Hemamalini Rajendrababu
Project Manager: Srikumar Narayanan
Design Direction: Ellen Zanolle
Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
CONTRIBUTORS
Alan A. Artru, MD
Gregory Crosby, MD
Professor, Associate Medical Director, and Chief of Anesthesia
Department of Anesthesiology
University of Washington School of Medicine
Seattle, Washington
Associate Professor of Anesthesia
Harvard Medical School
Brigham and Women’s Hospital
Boston, Massachusetts
Audrée A. Bendo, MD
Deborah J. Culley, MD
Professor and Vice-Chair for Education
Department of Anesthesiology
SUNY Downstate Medical Center
Brooklyn, New York
Assistant Professor of Anesthesia
Harvard Medical School
Boston, Massachusetts
Paolo A. Bolognese, MD
Department of Neurosurgery
The Chiari Institute, Harvey Cushing Institute of Neuroscience
North Shore-Long Island Jewish Health System
Manhasset, New York
Reader in Brain Physics
Department of Clinical Neurosciences
Neurosurgical Unit, University of Cambridge
Addenbrooke’s Hospital
Cambridge, United Kingdom
Meredith R. Brooks, MD, MPH
Karen B. Domino, MD, MPH
Clinical Instructor, Department of Anesthesia
Lucile Salter Packard Children’s Hospital
Stanford University Medical Center
Stanford, California
Professor of Anesthesiology and Pain Medicine
Vice Chair of Clinical Research
Adjunct Professor of Neurological Surgery
University of Washington School of Medicine
Seattle, Washington
Nicolas Bruder, MD
Professor of Anesthesiology and Intensive Care
Medical Director
CHU Timone, Université de la Méditerranée
Marseille, France
Jean Charchaflieh, MD, MPH
Associate Professor of Anesthesiology and Critical Care
Director of Anesthesiology Critical Care Program
SUNY Downstate Medical Center
Brooklyn, New York
Daniel J. Cole, MD
Professor of Anesthesiology
College of Medicine, Mayo Clinic
Chairman, Department of Anesthesiology
Mayo Clinic Arizona
Phoenix, Arizona
James E. Cottrell, MD, FRCA
Marek Czosnyka, PhD
Christopher F. Dowd, MD
Clinical Professor of Radiology and Biomedical Imaging,
Neurosurgery, Neurology, and Anesthesia and Perioperative Care
The Neurovascular Medical Group
Interventional Neuroradiology
University of California, San Francisco
San Francisco, California
Cassie L. Gabriel, MD
Chief Resident
Department of Anesthesiology
Loma Linda University
Loma Linda, California
Adrian W. Gelb, MBChB, FRCPC
Professor and Vice Chair for Faculty Affairs
Department of Anesthesia and Perioperative Care
University of California, San Francisco
San Francisco, California
Distinguished Professor and Chairman
Department of Anesthesiology
SUNY Downstate Medical Center
Brooklyn, New York
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
v
CONTRIBUTORS
Ian A. Herrick, MD, MPA, FRCPCA
Carlos J. Ledezma, MD
Associate Professor of Anesthesia and Clinical Pharmacology
University of Western Ontario
Director, Department of Anesthesia and ­Perioperative Medicine
London Health Sciences Centre
London, Ontario, Canada
Department of Radiology
Morristown Memorial Hospital
Morristown, New Jersey
Randall T. Higashida, MD
Clinical Professor of Radiology, Neurological Surgery,
Neurology and Anesthesia
Chief, Division of Neurointerventional Radiology
University of California, San Francisco Medical Center
San Francisco, California
Leslie Jameson, MD
Associate Professor and Vice Chair of Anesthesia
University of Colorado – Denver
Aurora, Colorado
Daniel Janik, MD
Associate Professor of Anesthesia
University of Colorado – Denver
Aurora, Colorado
Shailendra Joshi, MD
Assistant Professor
Department of Anesthesiology
College of Physicians and Surgeons of Columbia University
New York, New York
Ira Sanford Kass, PhD
vi
Professor of Anesthesiology and Physiology and
Pharmacology
State University of New York Downstate Medical Center
Brooklyn, New York
W. Andrew Kofke, MD, MBA, FCCM
Professor of Anesthesiology and Critical Care Medicine
Director of Neurosurgical Anesthesiology
Co-Director, Neurosurgical Critical Care
University of Pennsylvania
Philadelphia, Pennsylvania
Arthur M. Lam, MD, FRCPC
Professor of Anesthesiology and Neurological Surgery
University of Washington
Attending Anesthesiologist and Neurointensivist
Director of Cerebrovascular Laboratory
Harborview Medical Center
Seattle, Washington
Michael T. Lawton, MD
Professor of Neurological Surgery
Tong-Po Kan Endowed Chair
Chief, Cerebrovascular and Skull Base Surgery Programs
Director, Cerebrovascular Disorders Program
University of California, San Francisco
San Francisco, California
Baiping Lei, MD, PhD
Research Assistant Professor
Anesthesiology Department
SUNY Downstate Medical Center
Brooklyn, New York
Alex John London, PhD
Associate Professor of Philosophy
Director, Center for the Advancement of Applied Ethics
and Political Philosophy
Carnegie Mellon University
Pittsburgh, Pennsylvania
Michelle Lotto, MD
Oregon Anesthesiology Group
Portland, Oregon
Mishiya Matsumoto, MD
Professor of Anesthesiology
Yamaguchi University Graduate School of Medicine
Ube, Yamaguchi, Japan
Basil Matta, MD, FRCA
Divisional Director
Emergency and Perioperative Care
Associate Medical Director
Cambridge University Trust Hospitals
Cambridge, United Kingdom
Michael L. McManus, MD, MPH
Senior Associate in Medicine, Anesthesia and Critical Care
Children’s Hospital Boston
Associate Professor
Harvard Medical School
Boston, Massachusetts
Thomas H. Milhorat, MD
Department of Neurosurgery
The Chiari Institute, Harvey Cushing Institute of Neuroscience
North Shore-Long Island Jewish Health System
Manhasset, New York
Jonathan D. Moreno, PhD
David and Lyn Silfen University Professor
Professor of Medical Ethics, History and Sociology of Science
University of Pennsylvania
Philadelphia, Pennsylvania
Eugene Ornstein, MD, PhD
Associate Professor
Department of Anesthesiology
College of Physicians and Surgeons of Columbia University
New York, New York
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
Gary R. Stier, MD
Anesthesiology Faculty
Department of Anesthesiology
Virginia Mason Medical Center
Seattle, Washington
Associate Professor and Program Director
Department of Anesthesiology and Critical Care
Loma Linda University School of Medicine
Loma Linda, California
Patrick A. Ravussin, MD
Helen R. Stutz, DO
Professor
Head of Department of Anesthesiology
CHCVs Sion Hospital
Sion, Switzerland
Assistant Professor
Department of Anesthesiology and Critical Care
Albany Medical Center
Albany, New York
Angelique M. Reitsma, MD, MA
Pekka Talke, MD
Program Manager
Scattergood Program for the Applied Ethics of Behavioral
Health
University of Pennsylvania
Philadelphia, Pennsylvania
Professor
Department of Anesthesia and Perioperative Care
University of California, San Francisco
San Francisco, California
Irene Rozet, MD
Clinical Assistant Professor of Anesthesiology
SUNY Downstate Medical Center
Brooklyn, New York
Associate Professor of Anesthesiology
University of Washington
Seattle, Washington
Renata Rusa, MD
Associate Professor of Anesthesiology and Perioperative Medicine
Oregon Health and Science University
Portland, Oregon
Takefumi Sakabe, MD, PhD
Professor of Anesthesiology
Yamaguchi University Graduate School of Medicine
Ube, Yamaguchi, Japan
Armin Schubert, MD, MBA
Chair
Department of Anesthesiology
Ochsner Health System
New Orleans, Louisiana
Tod B. Sloan, MD, MBA, PhD
Professor of Anesthesia
University of Colorado Denver
Aurora, Colorado
David S. Smith, MD, PhD
Associate Professor of Anesthesiology and Critical Care
Department of Anesthesiology
University of Pennsylvania
Philadelphia, Pennsylvania
Sulpicio G. Soriano, MD, FAAP
Associate Professor of Anesthesia
Harvard Medical School
Children’s Hospital Endowed Chair in Pediatric
Neuroanesthesia
Senior Associate in Anesthesiology
Children’s Hospital Boston
Boston, Massachusetts
CONTRIBUTORS
Ryan P. Pong, MD
Lela Weems, MD
Max Wintermark, MD
Associate Professor of Radiology, Neurology and Neurosurgery
Director
Neuroradiology Division
University of Virginia
Charlottesville, Virginia
David J. Wlody, MD
Professor of Clinical Anesthesiology
Vice Chair for Clinical Affairs and Director of Obstetric
Anesthesia
SUNY Downstate Medical Center
Chairman of Anesthesiology
Long Island College Hospital
Brooklyn, New York
William L. Young, MD
James P. Livingston Professor and Vice Chair
Department of Anesthesia and Perioperative Care
Professor of Neurological Surgery and Neurology
Director
Center for Cerebrovascular Research
University of California, San Francisco
San Francisco, California
Mark H. Zornow, MD
Professor of Anesthesiology and Perioperative Medicine
Oregon Health Science University
Portland, Oregon
Connie Zuckerman, JD
Attorney and Consultant
Health Law and Bioethics
White Plains, New York
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
vii
This page intentionally left blank
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
FOREWORD
There have been many textbooks concerning the anesthetic
care of neurosurgical patients. Most appeared in one or two
versions and then disappeared. But this one has returned, edition after edition, since its inception in 1980, evolving and
improving with each version. I have got all four previous editions lined up in my bookcase. For this fifth edition, Dr. Cottrell is joined as co-editor by Dr. William Young, Professor
of Anesthesia at UCSF. Like Dr. Cottrell, Dr. Young has been
involved in neurosurgical anesthesia for a very, very long time.
In fact, on the basis of the dates of their initial publications,
these two editors have 60 years of clinical and scientific experience with this specialty between them.
In my foreword to the previous edition, I made the comment, “This is not a book for educating technicians, it’s a book
for educating professionals.” This remains true. There are
some new chapters and authors, some old chapters have disappeared, others have been rearranged. But the focus on the
underlying medicine and science of neuroanesthesia remains.
Why is this important? I realize that I’m repeating myself.
There are lots of “handbooks” on the market that provide recipes for all sorts of clinical scenarios—along with lots of “board
questions.” If your only interest in neuroanesthesia is in passing your boards, or if neurosurgical patients are a rare part of
your practice, these are OK. But if you think of yourself as a
neuroanesthesiologist and deal with such patients daily, you
must understand the underpinnings of your work. You need
to know the surgical diseases (and what to expect of patients
with such diseases), you need to understand the surgery itself,
you need to know the anatomy and physiology of the brain and
spinal cord, you need to know the science behind the practice.
No “handbook” can cover every situation that you encounter.
Doing anesthesia by recipe is an invitation to disaster—What
happens when the recipe wasn’t in your book? Nearly every
time I’m in the operating room, I encounter a patient who
“isn’t in the book”: the severely retarded and uncooperative
adult with hydrocephalus who has undergone a previous
occiput-C1 fusion; the pregnant woman with a subarachnoid
hemorrhage; the patient with a swollen, bleeding AVM; the
patient in whom the interventional radiologist has just perforated an aneurysm; the patient undergoing an awake temporal
lobectomy who convulses; the patient undergoing endoscopic
transsphenoidal hypophysectomy complicated by an inadvertent biopsy of the basilar artery—or in whom florid diabetes
insipidus develops on the table; the postop aneurysm patient
with severe vasospasm returning to the OR for an acute abdomen; the tumor patient who herniates in front of my eyes; the
quadriparetic patient undergoing both an anterior cervical
spine decompression and posterior fusion—or the C-spine
patient who awakens with an unexpected major deficit.
To develop an intelligent plan of action, to avoid or manage
these situations requires that you understand what you need to
do—not just depend on experience and do what you’ve been
told by your teachers. This is the definition of a medical professional.
This is a book for professionals. It is as up-to-date and as
comprehensive as it can be, in terms of both its science and
its practice. This is a book for anesthesiologists who truly see
themselves as real doctors, not just technicians.
Michael Todd, MD
Professor and Chairman
Department of Anesthesia
University of Iowa
Iowa City, Iowa
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
ix
This page intentionally left blank
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
PREFACE
With a new editor, William L. Young, and twenty-three new
authors, seven new chapters, three chapters with all new
authors, and eleven chapters with one or more new authors,
the fifth edition of Cottrell and Young’s Neuroanesthesia is both
track-tested and up-to-date. There was, of course, no option.
Ours is a fast-moving field. As the Red Queen said to Alice
in Wonderland, “Now, here, you see, it takes all the running
you can do, to keep in the same place.” In this case, “here” is
neurosurgical anesthesiology, and “the same place” is state-ofthe-art knowledge.
Medicine advances through a sort of trickle-down process.
Information flows from basic scientists to laboratory animal
researchers to clinical investigators to scientific journals to
c­ linical textbooks, and, finally, to clinicians. The closer the connections between the first four way stations and the textbook,
the better clinicians are served. We have kept those connections
tight by gathering authors who are, in various combinations,
basic scientists, laboratory researchers, clinical investigators,
journal authors, journal editors, and, of course, clinicians.
The emphasis of this book has always been clinical application, and that focus has only been sharpened in this fifth edition. We want this book to serve its readers by helping them
serve their patients.
James E. Cottrell and William L. Young
Editors
xi
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
This page intentionally left blank
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
ACKNOWLEDGMENTS
We thank our respective departments of anesthesiology, each
of which has provided, despite recent economic adversity, the
practical and intellectual background that makes it ­possible
for colleagues like ourselves to write, assemble, and edit such
books as Cottrell and Young’s Neuroanesthesia. Special thanks
are also due to Michael Todd for the new Foreword; Voltaire Gungab, John Hartung, Christine Waters, and Samrat
Worah for editorial assistance; Anne Minaidis for coordinating
the project; the publishing staff at Elsevier, Natasha Andjelkovic
and Bradley McIlwain; and especially the contributing authors
whose expertise has been particularly important in making
this edition possible.
James E. Cottrell
William L. Young
xiii
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
This page intentionally left blank
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
CONTENTS
Chapter 1Brain Metabolism, the Pathophysiology
of Brain Injury, and Potential Beneficial
Agents and Techniques, 1
Chapter 15Anesthetic Considerations for ­Surgical
Resection of Brain Arteriovenous
­Malformations, 264
Chapter 2Cerebral and Spinal Cord Blood Flow, 17
Chapter 16Occlusive Cerebrovascular Disease:
­Anesthetic Considerations, 278
Ira S. Kass • James E. Cottrell • Baiping Lei
Shailendra Joshi • Eugene Ornstein • William L.
Young
Chapter 3
Cerebrospinal Fluid, 60
Alan A. Artru
Chapter 4Intracranial Pressure Monitoring, 75
Paolo A. Bolognese • Thomas H. Milhorat
Chapter 5Effects of Anesthetic Agents and Other
Drugs on Cerebral Blood Flow,
Metabolism, and Intracranial Pressure, 78
Takefumi Sakabe • Mishiya Matsumoto
Chapter 6Modern Neuroradiology Relevant to
­Anesthetic and Perioperative
Management, 95
Carlos J. Ledezma • Max Wintermark
Chapter 7Evoked Potentials, 115
Tod B. Sloan • Leslie Jameson • Daniel Janik
Chapter 8Transcranial Doppler Ultrasonography in
Anesthesia and Neurosurgery, 131
Basil Matta • Marek Czosnyka
Chapter 9Fluid Management During
Craniotomy, 147
Renata Rusa • Mark H. Zornow
Chapter 10Care of the Acutely Unstable Patient, 161
Irene Rozet • Karen B. Domino
Chapter 11Supratentorial Masses: Anesthetic
­Considerations, 184
Nicolas Bruder • Patrick A. Ravussin
Chapter 12Anesthetic Management for Posterior
Fossa Surgery, 203
David S. Smith
William L. Young • Pekka Talke • Michael T. Lawton
Ian A. Herrick • Randall T. Higashida • Adrian W. Gelb
Chapter 17Awake Craniotomy, Epilepsy, Minimally
Invasive, and Robotic Surgery, 296
Armin Schubert • Michelle Lotto
Chapter 18Perioperative Management of Adult
Patients With Severe Head Injury, 317
Audrée A. Bendo
Chapter 19Pediatric Neuroanesthesia and Critical
Care, 327
Sulpicio G. Soriano • Michael L. McManus
Chapter 20Neurosurgical Diseases and Trauma of
the Spine and Spinal Cord: Anesthetic
Considerations, 343
Gary R. Stier • Cassie L. Gabriel • Daniel J. Cole
Chapter 21 Neurologic Disease and Anesthesia, 390
Deborah J. Culley • Meredith R. Brooks • Gregory Crosby
Chapter 22Postoperative and Intensive Care
­Including Head Injury and Multisystem
­Sequelae, 400
Helen R. Stutz • Jean Charchaflieh
Chapter 23Anesthesia for Neurosurgery in the
Pregnant Patient, 416
David J. Wlody • Lela Weems
Chapter 24Ethical Considerations in the Care of
Patients with Neurosurgical Disease, 425
Jonathan D. Moreno • Angelique M. Reitsma • ­
Connie Zuckerman • Alex John London
Chapter 25 Future Advances in Neuroanesthesia, 439
W. Andrew Kofke
Index, 455
Chapter 13Anesthetic Management of Cerebral
Aneurysm Surgery, 218
Ryan P. Pong • Arthur M. Lam
Chapter 14Interventional Neuroradiology:
­Anesthetic Management, 247
William L.Young • Christopher F. Dowd
http://www.us.elsevierhealth.com/product.jsp?isbn=9780323059084&elsca1=doodys&elsca2=PDF&elsca3=Cottrell9780323059084&elsca4=frontmatter
xv