Lumbar ryggm?rgsv?tskan drainage for Thoracoabdominal colorectal surgery: rationale and practical considerations for management
Go to main page content current issue past issues home CME subscribe ONLINE using the send to (A) and an activating my account search go advanced search? user name password sign in lumbar ryggm?rgsv?tskan drainage for Thoracoabdominal colorectal surgery: rationale and practical considerations for managing Christine a. Fedorow, MD *, Michael c. Moon, MD, FRCPC ?, w. Alan c. Mutch, MD, FRCPC * and Hilary p. GrocottVD, FRCPC * ?
From the Departments of *Anesthesia and ?Surgery, University of Manitoba, Winnipeg, Manitoba, Canada. Address correspondence and reprint requests to Hilary P. Grocott, MD, FRCPC, Departments of Anesthesia, University of Manitoba, I.H. Asper Institute for Clinical Research, CR3008-369 Tache Ave., Winnipeg, MB, Canada R2H 2A6. Address e-mail to hgrocott{at}sbgh.mb.ca. Abstract Paraplegia remains one of the most devastating complications of thoracoabdominal aortic surgery and is associated with a significant increase in both morbidity and mortality. Modern aortic repair techniques use many modalities aimed at reducing the risk of spinal cord ischemia inherent with surgical management. One of these modalities that acts via optimizing spinal cord blood flow is lumbar cerebrospinal fluid (CSF) drainage. Either alone or in combination with other interventions, CSF drainage remains one of the most frequently used spinal cord protection techniques. Despite no definitive proof of efficacy for reducing spinal cord injury, there are compelling data supporting its use. However, the potential benefit of CSF drainage must be balanced against the risks associated with its use, including nerve injury during insertion, compressive neuraxial hematoma formation, intracranial hemorrhage due to excessive drainage, and infection. The optimal benefit to risk ratio can be achieved by understanding the rationale for its use and following practical management guidelines. Footnotes Supported by internal departmental funding. Disclosure: The authors report no conflicts of interest. Copyright ? 2010 International Anesthesia Research Society ? Previous | Next Article ?Table of Contents This Article Published online before print June 3, 2010, doi: 10.1213/?ANE.0b013e3181ddddd6 A & A July 2010 vol. 111 no. 1 46-58 ? Abstract Full Text Full Text (PDF) CME Classifications Series: Review Articles Cardiovascular Anesthesiology Services Email this article to a colleague Alert me when this article is cited Alert me if a correction is posted Similar articles in this journal Similar articles in PubMed Download to citation manager Request Permissions Citing Articles Load citing article information Citing articles via Google Scholar Google Scholar Articles by Fedorow, C. A. Articles by Grocott, H. P. Search for related content PubMed PubMed citation Articles by Fedorow, C. A. Articles by Grocott, H. P. Related Content Cardiovascular Neuroanesthesia Anesthetic Techniques Patient Safety Load related web page information Current Issue June 2011, 112 (6) 
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