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
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