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Blood Pressure Changes in Paraplegics During Urological Manipulations

RODNEY A. MANNION, M.D.; THOMAS L. C. COTTRELL, M.D.; FREDERICK A. LLOYD, M.D.
AMA Arch Surg. 1959;78(6):949-951. doi:10.1001/archsurg.1959.04320060137020.
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Excessive sympathetic reactions occur in patients with injuries of the spinal cord following stimuli below the level of anesthesia. One of the most dramatic changes involves the cardiovascular system, in particular, the blood pressure.5 This report is concerned with blood pressure changes in a group of paraplegics which were produced by various urological procedures carried out at the Veterans Administration Hospital, Hines, Ill. The blood pressure changes are compared with those in patients without demonstrable spinal cord disease, undergoing similar procedures.

An attempt is made to define some of the hazards encountered in treating the paraplegic for urological disease, especially in regard to anesthetic difficulties which may stem from these procedures.

Data  Blood pressure changes were studied in 121 patients, 61 of whom were paraplegic. Of the latter, 27 had cervical cord lesions; 18, upper thoracic lesions; 9, lower thoracic lesions, and 7, lumbar cord dysfunctions. Sixty patients had

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