Impact of Controlled Induced Hypotension on Cognitive Functions of Patients Undergoing Functional Endoscopic Sinus Surgery.

BACKGROUND: Controlled induced hypotension guarantees less blood loss and better visibility of the surgical site. The impact of hypotension on post-operative cognitive functions is still being discussed. The objective of this study was to evaluate the effects of controlled induced hypotension on the cognitive functions of patients undergoing functional endoscopic sinus surgery (FESS). MATERIAL/METHODS: We allocated 47 patients with a good grade of preoperative cognitive functions evaluated with the Mini-Mental State Examination to 3 groups (1 - mild hypotension, 2 - intermediate hypotension, 3 - severe hypotension) according to the degree of mean intraoperative arterial pressure compared with preoperative blood pressure. Cognitive functions were evaluated preoperatively, 6 h, and 30 h postoperatively with standardized tests: the Stroop Test, Trail Making Test (TMT), and Verbal Fluency Test (VFT). A decrease in the test results and increase in the number of mistakes made were considered an impairment of cognitive functions. RESULTS: A total of 47 patients (group 1 - mild hypotension - 15, group 2 - intermediate hypotension - 19, group 3 - severe hypotension - 13) were included in the study. A significant decrease was observed in all the 3 groups after Stroop A test 6h postoperatively but it improved 30h postoperatively, without differences between the groups. Neither a significant decrease in the test results nor an increase in the number of mistakes was noted for Stroop B tests, TMT A&B tests and VFT. CONCLUSIONS: The degree of controlled intraoperative hypotension during FESS did not influence the results of psychometric tests.

Non-word reading test vs anaesthesia. How do anaesthetised patients decode the contents without referring to the meaning?

BACKGROUND: The aim of this study was to examine the phonological functioning (reading speed and accuracy) of hospital patients under general anaesthesia administered during colonoscopy. METHODS: In this study the 'Latysz' non-word reading test was used to measure the impact of selected anaesthetics on the phonological aspect of language processing (defined as decoding without referring to the meaning) in a group of 22 anaesthetised patients compared to 23 non-anaesthetised patients from university clinics. RESULTS: Compared to the preoperative performance, a decrease in reading accuracy and reading speed was observed only in the Anaesthesia Group - AG (in the subjects aged ≥ 35 years) 1.5 h after the administration of anaesthetics. Postoperatively, the AG were significantly slower and less accurate than the Control Group - CG - after 1.5 h. After 3 h, the AG had regained their baseline values both in reading accuracy and reading speed. During the last assessment session, the AG pronounced 82% of the words correctly, while the CG pronounced 74% correctly. Moreover, subjects aged ≥ 35 years performed worse than younger subjects in their reading accuracy and speed. CONCLUSIONS: The patients who underwent colonoscopy under general anaesthesia manifested impaired phonological functioning shortly after the procedure, both in the speed and accuracy of reading non-words. However, the accuracy problems subsided relatively quickly.

Evaluation of the Trail Making Test and interval timing as measures of cognition in healthy adults: comparisons by age, education, and gender.

BACKGROUND: Human cognitive functioning can be assessed using different methods of testing. Age, level of education, and gender may influence the results of cognitive tests. MATERIAL AND METHODS: The well-known Trail Making Test (TMT), which is often used to measure the frontal lobe function, and the experimental test of Interval Timing (IT) were compared. The methods used in IT included reproduction of auditory and visual stimuli, with the subsequent production of the time intervals of 1-, 2-, 5-, and 7-seconds durations with no pattern. Subjects included 64 healthy adult volunteers aged 18-63 (33 women, 31 men). Comparisons were made based on age, education, and gender. RESULTS: TMT was performed quickly and was influenced by age, education, and gender. All reproduced visual and produced intervals were shortened and the reproduction of auditory stimuli was more complex. Age, education, and gender have more pronounced impact on the cognitive test than on the interval timing test. The reproduction of the short auditory stimuli was more accurate in comparison to other modalities used in the IT test. CONCLUSIONS: The interval timing, when compared to the TMT, offers an interesting possibility of testing. Further studies are necessary to confirm the initial observation.

Psychomotor functions and interval timing in patients receiving intravenous anesthesia for endoscopic procedures: the pilot study.

Introduction. The aim of this study was to evaluate two measures in a cognitive examination: psychomotor function and the perception of time (PT) in patients after intravenous anesthesia for endoscopic procedures. Material and Methods. We tested 23 anesthetized patients (Anesthesia Group, AG) and 17 not anesthetized patients (Control Group, CG). The Dufour Cross-Shaped Apparatus (DA) was used to assess quick reactions. Perception of time (PT) was measured for 1-, 2-, 5-, and 7-second intervals. The tests were performed before the anesthesia was administered and 1.5, 3, and 6 hours after the procedure was completed. Results. The intervals that were generated and the reproduced visual stimuli were shorter than the patterns. The reproduced 1- and 2-second auditory stimuli were longer than the patterns. The remaining reproduced auditory impulses were shorter than the patterns. Conclusions. In anesthetized patients, quick psychomotor reactions and the ability to time intervals are preserved 1.5 h and later after intravenous anesthesia for endoscopy.

A randomized simultaneous comparison of acceleromyography with a peripheral nerve stimulator for assessing reversal of rocuronium-induced neuromuscular blockade with sugammadex.

BACKGROUND AND OBJECTIVE: We investigated the relationship between acceleromyography and a peripheral nerve stimulator for measuring reversal in patients administered sugammadex following rocuronium. METHODS: In this randomized, active and within-participant controlled study, patients received rocuronium 0.6 mg kg for intubation with 0.15 mg kg maintenance doses as required. Single-dose sugammadex 4.0 or 1.0 mg kg was given 15 min after the last rocuronium dose. Neuromuscular monitoring was performed simultaneously: acceleromyography on one forearm and a peripheral nerve stimulator on the other. The peripheral nerve stimulator assessor was blinded to acceleromyography results. The primary efficacy end point was the difference between time from start of sugammadex 4.0 mg kg administration to recovery of the train-of-four ratio to 0.9 (acceleromyography) and time to reappearance of the fourth twitch (T4) (peripheral nerve stimulator). RESULTS: Sixty-one patients received sugammadex 4.0 mg kg. With acceleromyography, mean (SD) recovery time to a train-of-four ratio of at least 0.9 was 1.5 (0.7) min. With both the peripheral nerve stimulator and acceleromyography, mean (SD) time to T4 reappearance was 0.8 (0.3) min. Mean (95% confidence interval) difference between time to T4 reappearance (peripheral nerve stimulator) and recovery to a train-of-four ratio of at least 0.9 (acceleromyography) was 0.8 (0.6-0.9) min. CONCLUSION: T4 is detected at similar times when measured by a peripheral nerve stimulator or acceleromyography following sugammadex 4.0 mg kg administration 15 min after rocuronium. The mean interval between T4 reappearance (peripheral nerve stimulator) and recovery to a train-of-four ratio of at least 0.9 (acceleromyography) was 0.8 min. These findings provide guidance for evaluating the reversal effect of sugammadex in clinical situations.

The first attempt at initiating problem-based learning as a method of teaching-learning at the University of Medical Sciences in Poznan, Poland.

The main objective of problem-based learning (PBL) is to provoke students to solve a new problem by themselves. The aim of this study was to investigate whether PBL was a better method of teaching basic and advanced life support to medical students compared with the classical method. The research was undertaken in 2002 in accordance with the European Guidelines 2000 and involved 36 medical students in year 4. The students were divided into two groups: experimental PBL group (17 students) and the control-classical method group (19 students). After the advanced life support course, the students wrote two tests to assess their knowledge on how to open the airway and how to perform basic and advanced resuscitation. The questions contained true or false answers. The students' skills of basic and advanced methods of opening the airway and advanced resuscitation were checked by practical tests. The Mann-Whitney test was used for statistical analysis. The experimental PBL group received significantly better results: 30-45 points (mean, 38.29 points) and 30-47 points (mean, 40.94 points) for the written and practical tests, respectively, compared with the control-classical group (22-34 points [mean, 29.36 points] and 22-35 points [mean, 28.63 points], respectively). Therefore, PBL offers a better method for teaching basic and advanced life support to medical students compared with the classical method.

Spectral frequency index monitoring during propofol-remifentanil and propofol-alfentanil total intravenous anaesthesia.

BACKGROUND: The aim of this study was to evaluate the usefulness of spectral frequency index (SFx) monitoring to assess the depth of anaesthesia during propofol-opioid total intravenous anaesthesia (TIVA). METHODS: Thirty-three patients scheduled for laparoscopic cholecystectomy under propofol TIVA were prospectively and randomly allocated to receive either remifentanil (bolus of 1.0 microg/kg, followed by continuous infusion from 0.25 to 0.05 microg/kg/min) [n = 18] or alfentanil (bolus of 10 microg/kg, followed by continuous infusion from 2.0 to 0.5 microg/kg/min) [n = 15]. EEG activity was monitored to achieve the desired depth of anaesthesia, and intravenous propofol was titrated to keep the SFx at 70-80%. The remifentanil and alfentanil groups were compared in relation to the plasma propofol concentration required for an adequate level of hypnosis during maintenance of anaesthesia, Pearson correlation coefficient for the relationship between the plasma propofol concentration and SFx values, recovery parameters, and recall of events during anaesthesia. RESULTS: The study groups were comparable with regard to demographic characteristics, type and duration of surgery, and time to resumption of spontaneous ventilation. No evidence of explicit recall was noted. The mean plasma propofol concentration required for an adequate level of hypnosis during maintenance of anaesthesia was significantly higher in the alfentanil group (3.20 microg/mL) compared with the remifentanil group (2.17 microg/L) [p < 0.05]. In both groups, the Pearson correlation coefficient test showed a linear correlation between SFx values and propofol concentration in the studied propofol concentration range. The mean time to orientation for name and place was significantly shorter (p < 0.05), the mean propofol concentration at orientation for name and place and at the resumption of spontaneous ventilation timepoints was significantly lower (both p < 0.01), and the mean SFx value at resumption of spontaneous ventilation timepoint was significantly higher (p < 0.01) in the remifentanil group. CONCLUSIONS: As SFx is linearly related to plasma propofol concentration, this index may be used to measure anaesthetic effect during propofol anaesthesia. The results of this clinical trial are consistent with a previous computer-simulated opioid-propofol model with regard to intraoperative and recovery variables, although the recovery occurred at different propofol concentration and SFx values.

Comparison of the influence of halothane and isoflurane on airway transepithelial potential difference.

Bidirectional transport of Na+ and Cl- ions by the epithelium controls production and composition of airway surface liquid and airway transepithelial potential difference and in these ways supports mucociliary transport. Volatile anesthetics are able to inhibit epithelial ion transport processes when applied at high concentration and have been suggested to elicit depression of airway clearance and both these effects could be involved in postoperative pulmonary complications. The goal of these studies was to reveal possible influence of halothane and isoflurane at lower concentrations on electrogenic ion transport in airway epithelium. These studies were performed on the isolated rabbit tracheal wall mounted in the Ussing chamber. The reaction of the preparation to the gentle mechanical stimulation performed as a jet flux was examined without or in the presence of anesthetics at concentration equivalent to 0.5 minimal anesthetic concentration of volatile anesthetics in pulmonary alveoli (MAC), 1 MAC, 2 MAC, 5 MAC and 10 MAC. The volatile anesthetics at concentrations equivalent to 5 and 10 MAC affected airway transepithelial potential difference and influenced hyperpolarization or depolarization reactions which occurred after mechanical stimulation. The above effects were present when Na+ transport was inhibited by amiloride. The disturbed epithelial Cl- transport may be proposed as an explanation of the action of volatile anesthetics on electrophysiological parameters of the isolated tracheal wall although the influence of anesthetics on tachykinin secretion from C-fiber endings, which are present in the preparation, should also be taken into consideration. The long-lasting action (tens of minutes) of volatile anesthetics on the isolated tracheal wall should be also studied in the future as a model of airway reaction to prolonged volatile anesthesia.

Comparative bioavailability study of two ibuprofen preparations after oral administration in healthy volunteers.

The bioavailability of a new ibuprofen (2-(p-isobutylphenyl)propionic acid, CAS 15687-27-1) preparation was compared with a reference preparation of the drug in 23 healthy male volunteers, aged between 19 and 27. A single dose of 400 mg was given orally in the fasted state, using a randomized two-way crossover study. A washout period of two weeks separated both treatment periods. Ibuprofen plasma levels were determined by means of a validated HPLC method (UV detector). Values of 154.48 +/- 53.27 microg x h/ml (95 % confidence interval CI: 133.50-177.03) for the test, and 140.86 +/- 44.82 microg x h/ml (95% CI: 122.53-159.16) for the reference preparation AUC(0-infinity) demonstrate a nearly identical extent of drug absorption. Maximum plasma concentrations Cmax of 39.53 +/- 7.11 microg/ml (95 % CI: 35.97-41.78) and 37.71 +/- 8.67 microg/ml (95% CI: 33.37-40.46) achieved for the test and reference preparations did not differ significantly. AUC(0-infinity) and Cmax ratios (90% CI) were within the 80-125% interval required for bioequivalence as stipulated in the current international regulations of the European Agency for the Evalution of Medicinal Products and the Food and Drug Administration. Therefore it is concluded that the new ibuprofen preparation is therapeutically equivalent to the reference preparation for both, the extent and the rate of absorption, after single dose administration in healthy volunteers.

Bioequivalence study of two losartan formulations administered orally in healthy male volunteers.

The bioavailability of a new losartan preparation (2-butyl-4-chloro-1-[p-(o-1H-tetrazol-5-ylphenyl)benzyl]imidazole-5-methanol monopotassium salt, CAS 114798-26-4) was compared with the reference preparation of the drug in 24 healthy male volunteers, aged between 19 and 32. The open, randomized, single-blind two-sequence, two-period crossover study design was performed. Under fasting conditions, each subject received a single oral dose of 100 mg losartan as a test or reference formulation. The plasma concentrations of losartan and its active metabolite were analyzed by a rapid and sensitive HPLC method with UV detection. The pharmacokinetic parameters included AUC0-36h, AUC0-infinity, Cmax, t1/2, and Ke. Values of AUC0-infinity demonstrate nearly identical bioavailability of losartan from the examined formulations. The AUC0-infinity of losartan was 2019.92+/-1002.90 and 2028.58+/-837.45 ng x h/ml for the test and reference formulation, respectively. The AUC0-infinity of the metabolite was 10851.52+/-4438.66 and 11041.18 +/-5015.81 ng x h/ml for test and reference formulation, respectively. The maximum plasma concentration (Cmax) of losartan was 745.94+/-419.75 ng/ml for the test and 745.74+/-329.99 ng/ml for the reference product and the Cmax of the metabolite was 1805.77+/-765.39 and 1606.22 +/-977.22 ng/ml for the test and reference product, respectively. No statistical differences were observed for Cmax and the area under the plasma concentration-time curve for both losartan and its active metabolite. 90 % confidence limits calculated for Cmax and AUC from zero to infinity (AUC0-infinity) of losartan and its metabolite were included in the bioequivalence range (0.8-1.25 for AUC). This study shows that the test formulation is bioequivalent to the reference formulation for losartan and its main active metabolite.

Comparative bioavailability study of two preparations of letrozole in healthy subjects.

The bioavailability of a new letrozole (CAS 112809-51-5) preparation was compared with the reference preparation of the drug in 25 healthy volunteers, aged between 18 and 33. A single dose of 2.5 mg was given orally in the fasted state, using a randomized two-way, cross-over protocol. A washout period of two weeks separated both treatment periods. Blood samples were obtained at regular time intervals, until 312 h after drug administration. After solid phase extraction (SPE) letrozole plasma levels were measured by high pressure liquid chromatography that was validated before the start of the study (UV detector, fluoroletrozole as an internal standard). The limit of quantification was 1.4 nmol/ml. The following pharmacokinetics parameters were calculated from letrozole plasma concentrations: AUC(0-infinity), AUC(0-t), Cmax, tmax, F(rel), MRT, t(1/2), k(el). The confidence intervals for the statistical calculations of AUC(0-infinity), Cmax, tmax were 95 % and AUC(0-t), MRT, t(1/2), k(el) were tested by means of the unpaired t-tests procedure and after logarithmic transformation for overall significant differences using analysis of variance--three-way ANOVA. The AUC(0-infinity) ratio test/reference and the 90 % confidence interval were 99.52 %, and 94.05-107.31%, respectively. The Cmax ratio test/reference and the 90 % confidence interval were 89.18 %, and 84.48-98.60%, respectively. AUC(0-infinity) and Cmax ratios (90 % CI) were within the 80-125 % interval required for bioequivalence as stipulated in the current international regulations of the European Agency for the Evalution of Medicinal Products and the Food and Drug Administration. Therefore it is concluded that the new letrozole preparation is therapeutically equivalent to the reference preparation for both the extent and the rate of absorption after single dose administration in healthy volunteers.

Effects of halothane and isoflurane on stimulated airway transepithelial ion transport.

Volatile anesthetics are suggested to elicit depression of airway clearance. The involvement of changes in transepithelial ion transport in this inhibition has already been observed. The Ussing method was used to study the changes in mechanical stimulation evoked electrogenic ion transport in isolated rabbit tracheal wall in the presence of halothane and isoflurane. The drugs dissolved in Ringer solution were directed as a flux from peristaltic pump to mucosal surface of trachea. In experimental settings without or with amiloride, the anestethics elicited reversible inhibition of stimulated ion transport and depolarization of transepithelial potential difference. Participation of chloride ion transport in observed changes is suggested. In the light of this study with application of anesthetics at higher concentrations than clinically relevant, the possibility of disturbances of airway transepithelial ion transport by clinically relevant concentration should be checked.

Bioavailability study of drotaverine from capsule and tablet preparations in healthy volunteers.

The bioavailability of drotaverine (CAS 14009-24-6) was investigated after oral administration of a drotaverine capsule preparation (20 mg Droxa mite) and compared to that of a reference tablet preparation. The preparations were investigated in 23 healthy volunteers, aged between 20 and 27 years, according to a randomised two-way, cross-over design in the fasted state. Blood samples for determination of drotaverine plasma concentrations were collected at pre-defined time points up to 30 h following drug administration. A washout period of two weeks separated both treatment periods. Drotaverine plasma concentrations were determined by means of a validated HPLC method (UV detector, imipramine HCl salt as an internal standard). The limit of detection was 6 ng/ml. Values of 1593.92 +/- 949.70 ng x h/l (95% confidence interval (CI): 1183.20-2004.60) for the test and 1705.48 +/- 737.78 ng x h/l (95% CI: 1386.40-2024.50) for the reference preparation AUC(0-infinity) demonstrate a nearly identical extent of drug absorption. Maximum concentrations--Cmax of 121.89 +/- 37.03 ng/ml (95% CI: 104.05-139.80) and 121.85 +/- 37.97 ng/ml (95% CI: 107.09-135.74) and time to reach maximum plasma concentration--Tmax of 1.29 +/- 0.42 h (95% CI: 1.11-1.48) and 1.14 +/- 0.34 h (95% CI: 0.99-1.29) achieved for the test and reference preparations did not differ significantly. The relative bioavailability (AUC(0-infinity) ratio test/reference) and Cmax ratio test/reference were 103.15% (90% CI: 81.68-124.60) and 103.74% (90% CI: 94.10-113.38), respectively. AUC was calculated using two different methods. There were no significant differences between the obtained values. Since the 90% CI for both, AUC and Cmax ratios were within the 80-125% interval proposed by the European Agency for the Evalution of Medicinal Products (CPMP) and the Food and Drug Administration, it is concluded that the new drotaverine capsule formulation is therapeutically equivalent to the conventional formulation for both, the extent and the rate of absorption after single dose administration in healthy volunteers.

Oxidative metabolism of peripheral blood neutrophils in experimental acute hypercapnia in the mechanically ventilated rabbit.

BACKGROUND AND AIM: The aim of this study was to investigate the effect of acute hypercapnia due to the mechanical hypoventilation on the oxidative metabolism of peripheral blood neutrophils in the rabbit. METHODS: The study was performed on 24 Chinchilla rabbits, randomized into normo- and hypercapnia groups (P(a)CO(2) between 9 and 11 kPa over 180 min). At the baseline point and after 180 min of mechanical ventilation, a neutrophil count, luminol-dependent chemiluminescence of the neutrophils stimulated with opsonized zymosan (OZ) or PMA (phorbol myristate acetate), and the hydrogen peroxide production of the cells upon the PMA stimulation were measured. Serum cortisol levels were additionally determined. RESULTS: In both studied groups, a significant neutrophilia after 180 min of mechanical ventilation was observed (P<.05). Neither chemiluminescence nor hydrogen peroxide production of peripheral neutrophils was changed (P>.05). CONCLUSIONS: Hypercapnia lasting for 180 min did not affect the oxidative metabolism of circulating neutrophils but a rise in a neutrophil count was observed in the mechanically ventilated rabbit.

The influence of acute hypercapnia on the quantity and oxidative metabolism of bronchoalveolar lavage-derived leukocytes in the mechanically ventilated rabbit.

BACKGROUND: Permissive hypercapnia exerts a protective influence in tissue injury, possibly by attenuating free radical activity. Increased CO2 concentrations may decrease the production of phagocyte reactive oxygen intermediates (ROI). In this study, we used bronchoalveolar lavage (BAL) to determine whether isooxic permissive hypercapnia due to hypoventilation would influence neutrophil recruitment into alveolar spaces and ROI production of BAL phagocytes, as measured by luminol dependent chemiluminescence. MATERIAL/METHODS: 27 Chinchilla rabbits randomized into three groups: control group (C; n=7), normocapnia (NC; n=10), and hypercapnia (HC; n=10) were anaesthetized with pentobarbitone and intubated. Bronchoalveolar lavage was obtained either after intubation (controls) or after mechanical ventilation lasting 240 minutes under normocapnia or permissive hypercapnia conditions. BAL cells were counted and luminol-dependent chemiluminescence estimations were performed. RESULTS: The BAL neutrophil count was significantly higher in the hypercapnia group than in normocapnia animals. The chemiluminescence of opsonized zymosan-stimulated cells was significantly higher in the normocapnia group than in the controls; the differences between the HC and NC animals, and between the HC and control animals, did not reach statistical significance. CONCLUSIONS: In the mechanically ventilated rabbit under pentobarbitone anaesthesia, acute isooxic hypercapnia due to hypoventilation increases neutrophil BAL count, without direct impact on mixed BAL-cell chemiluminescence; moreover, conventional ventilation increases the chemiluminescence of opsonized zymosan-stimulated BAL cells

The rate of loss of eyelid reflex following thiopental administration in hypo- and hypergonadism in rabbits.

BACKGROUND: The aim of this research was to explain whether different hormonal conditions caused by disturbed concentrations of estrogens and progesterone might lead to alteration of CNS reaction following administration of the hypnotic agent thiopental. The investigated factor was the rate of loss of the eyelid reflex after intravenous thiopental administration, since this corresponds with loss of consciousness. MATERIAL/METHODS: The investigation was performed in 24 sexually mature female Chinchilla rabbits divided into 4 groups of 6 rabbits each. The animals were oophorectomized (hypoprogesterone/hypoestrogen), hyperestrogen (sham surgery plus estradiol injections), hyperprogesterone (sham surgery plus 17 alpha-hydroxyprogesterone injections), or normal (sham surgery). Twelve weeks later, thiopental (40 mg/ml) was infused through the intravenous cannula at a constant rate (90 ml/hour) until loss of the eyelid reflex, at which time blood was sampled for determination of thiopental, b-estradiol, progesterone and 17 alpha-hydroxyprogesterone concentrations. The ANOVA and Tukey tests were applied in statistical analysis (p=0.05). RESULTS: Hyperprogesterone rabbits lost consciousness faster (138 +/- 34.6 sec), at a lower plasma thiopental concentration (46.3 +/- 6.6 microg/ml), and required less thiopental (24.63 +/- 6.44 mg/kg) than controls; hypoprogesterone rabbits lost consciousness slower (207.5 +/- 30.9 sec), at a higher plasma thiopental concentration (129.2 +/- 24.9 microg/ml), and required more thiopental (38.51 +/- 2.33 mg/kg) than controls. The time of sleep induction in the control group was 190 +/- 25.7 sec.; the serum thiopental concentration was 77.8 +/- 13.9 microg/ml, and the total thiopental consumption was 35.8 +/- 3.51 mg/kg. Estrogen status has no effect. CONCLUSIONS: Various hormonal states are accompanied by different CNS reactions to thiopental. Among the studied groups of sex steroids, only progestins significantly modify the CNS response to barbiturate infusion.

[Pregnancy induced arterial hypertension--an attempt to evaluate hermetic aspects of the blood-brain barrier connected with skull computed tomography]. / Stan przedrzucawkowy--próba oceny szczelnosci bariery krew-mózg w polaczeniu z badaniem tomografii komputerowej glowy.

The aim of the work was to study the influence of pregnancy induced arterial hypertension (PIH) on hermetic aspects of the blood-brain barrier. Neurological consultation was followed by cranial computed tomography which revealed changes within structures of central nervous system. The observations were performed in 6 pregnant women, assigned to control group--C, and study group--G. All women had caesarean section performed in conductive anaesthesia. The method included collection of 15 ml venous blood and 4 ml cerebrospinal fluid (CSF). Albumin and immunoglobulin G (IgG) serum concentrations, micro-albumin and IgG CSF concentrations, and permeability indexes for albumin and IgG--Qalb and QIqG, were estimated. In contrast to group C, increased Qalb and QIgG indexes proved lack of integrity of blood-brain barrier in the group G. Control cranial CT scans revealed partial subsidence of changes after 3-5 days, and complete subsidence after 9-14 days.