English

Abstract

BACKGROUND There are extensive variations in central venous pressure during intraoperative period of a major neurosurgical patients. Monitoring of central venous pressure is vital for guiding the administration of fluids, blood and blood products. Central venous pressure (CVP) also measures the intracranial pressure indirectly. Increased intracranial pressure thereby reduces the cerebral blood flow, leading to cerebral ischemia. METHODS This is a prospective study where 25 major neurosurgical cases posted for elective major neurosurgery were selected. Right subclavian vein was selected for cannulation, by blind technique in all these cases. CVP was recorded every 15 minutes. Central venous catheter was connected to a pressure transducer linked to a multichannel monitor; zeroing was done and the CVP reading obtained. RESULTS Central venous pressure reading was done serially and showed the trends in haemodynamics in various stages of surgery. Initial intraoperative periods showed lower values due to intravenous (I / V) induction of anaesthesia, use of mannitol and diuretics. Later on, the trends changed to higher side subsequent to administration of fluids and blood as required. CONCLUSIONS Monitoring of CVP is an important component of haemodynamic monitoring along with non-invasive blood pressure (NIBP), intra-arterial blood pressure (IABP), and urine output. Central venous pressure can be used to aspirate an air embolism occurring during the intraoperative period after employing Durant’s position. KEYWORDS CVP, NIBP , USS – Ultra Sound Scan, IVC – Inferior Vena Cava, IVCCI – Inferior Vena Cave Collapsibility Index, PEEP – Positive End Expiratory Pressure, C / L – Central Line, IABP.