Case 28 Craniotomy for Brain Mass Excision
Clinical Pearls
1. The preoperative evaluation of a patient for craniotomy should include knowledge of the size, location, vascularity, and nature of the SOL as this can influence positioning of the patient, surgical blood loss, and line placement.
2. Intracranial pressure is dynamically influenced by blood pressure, PaCO2 , and most anesthetics.
3. Elevated ICP can be reduced by head elevation to 30 degrees in combination with diuretics, that is, furosemide and mannitol, moderate hyperventilation, reducing the mean arterial pressure, and in some cases by drainage of CSF.
4. The goal of anesthesia for craniotomy is to maintain cerebral perfusion, reduce CMRO2, preserve blood flow and hence oxygenation to “at-risk areas,” and to optimize operating conditions.
1. adhere to v.坚持；依附to obey a rule, law, agreement, etc.; to support or believe in an idea, plan, opinion, etc. // They are required to adhere to physical distancing and strict hygiene measures. 这些场所必须遵守社交距离以及严格的卫生措施。
2. depolarizing muscle relaxant 去极化型肌松药
nondepolarizing muscle relaxant 非去极化型肌松药
3. hyperkalemia [haɪpə:kə'li:mɪə] n.高血钾
potassium [pə'tæsiəm] n.钾
millimole ['mɪlɪməʊl] n.毫克分子量
4. periosteum [ˌperɪ'ɒstɪəm] n.【解】骨膜 n.a dense fibrous membrane covering the surface of bones (except at their extremities) and serving as an attachment for tendons ( ['tendən] n.腱) and muscles.
5. remifentanil 瑞芬太尼 Remifentanil is an opioid with a unique pharmacokinetic profile. Its metabolism by nonspecific esterases (['estəreɪs] n.【化】酯酶) results in rapid and uniform clearance leading to highly predictable onset and offset of action.
6. hypocarbia ['haɪpəkɑ:bɪə] n.低碳酸血症 Hypocarbia, also known as hypocapnia, is a decrease in alveolar and blood carbon dioxide (CO2) levels below the normal reference range of 35 mmHg.
7. craniotomy [ˌkreɪnɪ'ɒtəmɪ] n.【医】颅骨切开术
8. intracellular [ˌɪntrə'seljʊlə] adj.细胞内的 → extracellular[ˌekstrə'seljʊlə] adj.【生】细胞外的
9. hyperglycemia [ˌhaɪpə(r)ɡlaɪˈsiːmiə] n.【医】高血糖 The term "hyperglycemia" is derived from the Greek hyper (high) + glykys (sweet/sugar) + haima (blood).
medulloblastoma
[mə'dʌlələnblæ'təʊmə] n.髓母细胞瘤
10. posterior fossa tumor [pɒˈstɪəriə(r)] ['fɒsə]【医】 后颅窝肿瘤 Posterior fossa tumor is a type of brain tumor located in or near the bottom of the skull. The posterior fossa ([pɒˈstɪəriə(r)] ['fɒsə] 后颅窝) is a small space in the skull, found near the brainstem and cerebellum. The cerebellum ([.serə'beləm] n.小脑) is the part of the brain responsible for balance and coordinated movements.
11. vasomotor [ˌvæsə'məʊtə] adj.【生】血管舒缩的 refers to actions upon a blood vessel which alter its diameter. More specifically, it can refer to vasodilator action and vasoconstrictor action.
12. glossopharyngeal [ˌglɒsəʊfə'rɪndʒɪəl] adj.【解】舌咽的 relating to the tongue and pharynx ([ˈfærɪŋks] n.咽）
13. vagus ['veɪgəs] n.【解】迷走神经 a mixed nerve that supplies the pharynx and larynx ([ˈlærɪŋks] n.喉) and lungs and heart and esophagus ([iːˈsɒfəɡəs] n.食道) and stomach and most of the abdominal viscera (['vɪsərə] n.内脏；脏腑)
14. gag reflux 咽反射 A gag ([ɡæɡ]) reflex, or pharyngeal reflex, is a normal bodily response. It prevents swallowing by contracting the pharynx. The pharynx is the passageway from the mouth and nose into the esophagus (food pipe), the tube that connects the throat to the stomach.
15. an acoustic neuroma 听神经瘤 a benign tumor that develops on the auditory ([ˈɔːdɪt(ə)ri] adj.听的) nerve causing hearing loss, loss of balance, and headaches
acoustic [əˈkuːstɪk] adj.声音的；音响的；
neuroma [njʊə'rəʊmə] n.【医】神经瘤n. (pl. neuromas, -mata)
16. venous air embolism (VAE) 静脉空气栓塞
Case Files: Anesthesiology 学习笔记(112)颅内占位开颅切除术5. / Case Files: Anesthesiology 学习笔记(111)颅内占位开颅切除术4. / Case Files: Anesthesiology 学习笔记(110)颅内占位开颅切除术3. / Case Files: Anesthesiology 学习笔记(109)颅内占位开颅切除术2. / Case Files: Anesthesiology 学习笔记(108)颅内占位开颅切除术1.
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