Paraplegia can be caused by different factors like rupture or repair of the aortic aneurysm or aortic thrombosis, aortic dissection, anterior spinal cord artery emboli, coagulation disorders and lupus disease, all of which cause impaired spinal cord blood flow and spinal cord ischemia. In addition, hypotension may be the cause of spinal cord infarction but Medline researches have reported a few cases of spinal cord infarction in patients laparotomized for the reasons other than aortic lesions. In this paper we report one case of paraplegia who had experienced spinal infarction and paraplegia after internal bleeding and two times laparatomies due to long lasting hypotension. In this case regarding the patient ’ s age, occupation and physical health, the possibility of cardiovascular lesions and consequent thromboembolism seems very unlikely. Furthermore, considering the two operations performed and the temporal space between them, the only factor that could have led to ischemia and infarction of the spinal cord in this patient is long-standing hypotension.

Background & objectives: Surgery of upper part of femor in elderly patients can be due to the fracture of femoral neck, shaft and arthroplasty. Hemodynamic changes and complications of the anesthesia are among the major concerns. The aim of this study was to compare the hemodynamic changes in low dose isoflurane with propofol in upper femoral surgeries in elderly patients.

Methods: This prospective clinical trial study was done on 60 patients over 65 year-old elderly patients with ASA physical status of I and II that were candidate for upper femoral surgery in two groups (inhalational: isoflurane 0.5-0.6 MAC) and (total intravenous anesthesia with propofol 50-100 mic/kg/min). Hemodynamic changes were compared in these groups with the same anesthetic depth (HR-SBP-DBP-MBP-SaO₂).

Results: There was no significant difference in heart rate, age or sex between two groups. In isoflurane group SBP on 20 and 25^th minutes and DBP and MBP on 20, 25 and 35^th minutes were significantly higher than propofol group. In propofol group SaO₂ was significantly more than isoflurane group on induction, start of surgery and on 5, 25, 35 and 45^th minutes of surgery.

Conclusion: In anesthesia with the same Bi-Spectral Index, isoflurane provides more stable hemodynamic parameters than propofol.