AUTHOR=Nie Pan , Chen Mengxi , Zhang Jibo , Pan Meicheng , Gu Xiqian , Xu Chengshi , Li Zhengwei , Zhang Jianjian , Zhao Wenyuan , Li Xiang , Zhang Jie , Chen Jincao 

TITLE=A new neurosurgical adjustable pressure suction apparatus with a mechanically controlled air inlet: the study of precise regulation and atraumatic suction

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.979494

DOI=10.3389/fneur.2022.979494

ISSN=1664-2295

ABSTRACT=Background: The suction tube is an indispensable operative instrument in neurosurgery. Flexible and reasonable application of suction tube facilitate the neurosurgical operation.
Objective: This study is to verify the practicality of adjustable pressure suction tube (APS-tube) and explore the appropriate diameter, tip negative pressure of APS-tube for different intracranial structures.
Methods: Brain tissue and carotid artery of rats were sucked by APS-tube. Laser speckle contrast imaging (LSCI) was used to record the blood flow velocity (BFV). We measured the tip negative pressure, diameter, air inlet size of APS-tube, and center negative pressure and calculated their correlation. Intraoperative real-time parameters were recorded.
Results: When tip negative pressure exceeded 33.4±1.8kpa and 29.2±2.0kpa, it caused severe damage to carotid arteries and brain tissue of rats, respectively. BFV could not return to the preoperative level 3 minutes after the operation (P<0.05), and this decrease was more pronounced when the suction tube diameter was larger (P<0.05). Tip negative pressure was positively correlated with central negative pressure, negatively correlated with air inlet size, and independent of APS-tube diameter. When important structures such as Motor cortex, brainstem were involved, APS-tube with diameter of 1.5 or 2.0mm were mostly used, and the air inlet was opened for about 0.7-2.1mm to maintain a safe tip negative pressure (7.4-27.9kpa).
Conclusion: Inappropriate application of suction tube can cause severe intracranial structural damage, even result in an irreversible reduction in BFV. The APS-tube can liberate the way of holding suction tube and be easily adjusted and maintain relatively stable tip negative pressure.