Surgical Techniques in Aneurysm Clipping
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Questions and Answers

What is the primary purpose of using EEG monitoring during flow interruption?

  • To predict the necessity of occlusion
  • To guide the administration of anesthetic agents
  • To increase blood flow to the brain
  • To monitor for major ischemic events (correct)
  • What is the common practice if EEG shows significant slowing during temporary occlusion?

  • Continue with the occlusion without changes
  • Raise the mean arterial pressure (MAP) (correct)
  • Extend the duration of occlusion
  • Administer barbiturates immediately
  • When might it be appropriate to administer barbiturates during occlusion?

  • If EEG shows significant slowing (correct)
  • If there is no significant EEG activity
  • At the beginning of any occlusion
  • If intermittent episodes of occlusion are needed
  • What is the purpose of a temporary occlusion before proceeding with a sustained period?

    <p>To observe changes in EEG</p> Signup and view all the answers

    Why might a surgeon place an electrode strip over the cortex at risk during occlusion?

    <p>To monitor for changes in brain activity</p> Signup and view all the answers

    What is an important brain protection technique during surgery according to the text?

    <p>Limitation of the duration of temporary occlusion episodes</p> Signup and view all the answers

    Why is etomidate not recommended for use during surgery according to the text?

    <p>It has demonstrated an adverse effect in focal ischemia animal models</p> Signup and view all the answers

    What is the key consideration for choosing an anesthetic regimen during aneurysm procedures based on the text?

    <p>Precise hemodynamic control and timely wake-up</p> Signup and view all the answers

    What is suggested as the minimum hemoglobin value for patients undergoing aneurysm surgery based on the text?

    <p>&gt;9 g/dL</p> Signup and view all the answers

    Why are barbiturates reserved for specific situations during surgery according to the text?

    <p>Potential adverse effects on hemodynamics and wake-up</p> Signup and view all the answers

    What is the purpose of placing a temporary clip proximally on the feeding vessel during an aneurysm surgery?

    <p>To facilitate the dissection of the neck and apply the permanent clip</p> Signup and view all the answers

    In which situation is it occasionally necessary to trap the aneurysm during surgery?

    <p>For giant aneurysms near the carotid siphon</p> Signup and view all the answers

    What does a clinical survey reveal about temporary occlusion in normothermic, normotensive adults?

    <p>Ischemic injuries are inevitable with occlusions exceeding 14 minutes</p> Signup and view all the answers

    Why is it recommended to sustain MAP at high-normal levels during temporary occlusion?

    <p>To facilitate collateral CBF</p> Signup and view all the answers

    What is a common informal rule applied to individual periods of temporary occlusion?

    <p>7-minute rule</p> Signup and view all the answers

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