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Journal of Neurosurgical Anesthesiology

Ana Leitão Ferreira, Rui Correia, Sérgio Vide, Ana Dias Ferreira, Max B Kelz, Joaquim Gabriel Mendes, Catarina S Nunes, Pedro Amorim
BACKGROUND: Recovery of consciousness is usually seen as a passive process, with emergence from anesthesia depicted as the inverse process of induction resulting from the elimination of anesthetic drugs from their central nervous system sites of action. However, that need not be the case. Recently it has been argued that we might encounter hysteresis to changes in the state of consciousness, known as neural inertia. This phenomenon has been debated in neuroanesthesia, as manipulation of the brain might further influence recovery of consciousness...
October 26, 2018: Journal of Neurosurgical Anesthesiology
Nan Lin, Laszlo Vutskits, John F Bebawy, Adrian W Gelb
The α2-adrenergic receptor agonist dexmedetomidine has sedative, anxiolytic, analgesic, and sympatholytic effects. The potential advantages of neuroprotection, minimal impact on neuronal function, stable hemodynamics, opioid and anesthesia sparing effects, and minimal respiratory depression during awake procedures render it an effective anesthetic adjuvant in various neurosurgical settings. However, both the benefits and drawbacks of the use dexmedetomidine in neuroanesthesia should be considered. This narrative review will summarize the applications of dexmedetomidine in various neurosurgical settings, highlighting evidence regarding both its common and controversial uses...
October 22, 2018: Journal of Neurosurgical Anesthesiology
Amie L Hoefnagel, Shobana Rajan, Adriana Martin, Vibha Mahendra, Amanda K Knutson, Jamie L Uejima, Guy Kositratna, Mark Weller, Hui Yang, Sanchit Ahuja, Caryl Bailey, John F Bebawy
Cognitive aids and evidence-based checklists are frequently utilized in complex situations across many disciplines and sectors. The purpose of such aids is not simply to provide instruction so as to fulfill a task, but rather to ensure that all contingencies related to the emergency are considered and accounted for and that the task at hand is completed fully, despite possible distractions. Furthermore, utilization of a checklist enhances communication to all team members by allowing all stakeholders to know and understand exactly what is occurring, what has been accomplished, and what remains to be done...
October 16, 2018: Journal of Neurosurgical Anesthesiology
Tak Kyu Oh, Jung-Hee Ryu, Hye-Min Sohn, Young-Tae Jeon
BACKGROUND: Although hypothermia is known to have protective effects against ischemic injuries, the effects of hypothermia on kidney injury have not yet been elucidated. Therefore, this study aimed to identify the association between intraoperative hypothermia and postoperative acute kidney injury (AKI) in patients who underwent spine surgery under general anesthesia. METHODS: In this retrospective observational study, we analyzed the medical records of adult patients who underwent elective spine surgery between January 2010 and March 2018...
October 16, 2018: Journal of Neurosurgical Anesthesiology
Bertram Baenziger, Najia Nadi, Ramon Doerig, Peter Proemmel, Brigitta Gahl, Daniel Hodel, Oliver N Hausmann
BACKGROUND: There are only a few prospective clinical trials investigating the effects of different anesthetic techniques on clinical outcomes after lumbar spine surgery. The purpose of this study was to evaluate clinical outcomes in patients receiving general (GA) and regional anesthesia (RA) for lumbar spine surgery. METHODS: This was a single-center, 2-arm, trial in which 100 patients undergoing lumbar spine surgery were randomized to receive either RA or GA (50 per group)...
October 16, 2018: Journal of Neurosurgical Anesthesiology
Samuel Natzeder, David J Mack, Gabriela Maissen, Christian Strässle, Emanuela Keller, Carl Muroi
BACKGROUND: Portable automated infrared pupillometry is becoming increasingly popular. To generate an objective reference base, the Neurological Pupil index (NPi) which combines different values of the pupillary light reflex is being introduced into clinical practice. In this explorative study, we examined different aspects of the NPi in relation to clinical severity and outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). MATERIALS AND METHODS: Patients with serial assessment of the NPi (NeurOptics pupillometer NPi-200, Irvine, CA) starting no later than day 2 after aSAH onset were included in the study...
October 9, 2018: Journal of Neurosurgical Anesthesiology
Edoardo Picetti, Mauro Oddo, Lara Prisco, Raimund Helbok, Fabio Silvio Taccone
BACKGROUND: Fever is common in patients with acute brain injury and worsens secondary brain injury and clinical outcomes. Currently, there is a lack of consensus on the definition of fever and its management. The aims of the survey were to explore: (a) fever definitions, (b) thresholds to trigger temperature management, and (c) therapeutic strategies to control fever. MATERIALS AND METHODS: A questionnaire (26 items) was made available to members of the European Society of Intensive Care Medicine via its website between July 2016 and December 2016...
September 29, 2018: Journal of Neurosurgical Anesthesiology
Abolfazl Firouzian, Afshin Gholipour Baradari, Saeid Ehteshami, Alieh Zamani Kiasari, Misagh Shafizad, Sajad Shafiei, Fatemeh Younesi Rostami, Abbas Alipour, Shahram Ala, Hadi Darvishi-Khezri, Kaveh Haddadi
BACKGROUND: Despite advances in pain management, several patients continue to experience severe acute pain after lumbar spine surgery. The aim of this study was to assess the safety and effectiveness of single ultra-low-dose intrathecal (IT) naloxone in combination with IT morphine for reducing pain intensity, pruritus, nausea, and vomiting in patients undergoing lumbar laminectomy with spinal fusion. MATERIALS AND METHODS: In this double-blind trial, patients scheduled for lumbar laminectomy with spinal fusion were randomly assigned to receive single ultra-low-dose IT naloxone (20 μg) and IT morphine (0...
September 29, 2018: Journal of Neurosurgical Anesthesiology
Stefano Spina, Vittorio Scaravilli, Giovanni Cavenaghi, Dario Manzolini, Chiara Marzorati, Enrico Colombo, Davide Savo, Alessia Vargiolu, Giuseppe Citerio
BACKGROUND: Brain-injured patients frequently require tracheostomy, but no technique has been shown to be the gold standard for these patients. We developed and introduced into standard clinical practice an innovative bedside translaryngeal tracheostomy (TLT) technique aided by suspension laryngoscopy (modified TLT). During this procedure, the endotracheal tube is left in place until the airway is secured with the new tracheostomy. This study assessed the clinical impact of this technique in brain-injured patients...
August 29, 2018: Journal of Neurosurgical Anesthesiology
Arnoley S Abcejo, Jeffrey J Pasternak, William J Perkins
BACKGROUND: Venous air embolism (VAE) is a well-described complication of neurosurgical procedures performed in the seated position. Although most often clinically insignificant, VAE may result in hemodynamic or neurological compromise resulting in urgent change to a level position. The incidence, intraoperative course, and outcome in such patients are provided in this large retrospective study. METHODS: Patients undergoing a neurosurgical procedure in the seated position at a single institution between January 2000 and October 2013 were identified...
August 24, 2018: Journal of Neurosurgical Anesthesiology
Min Zeng, Jia Dong, Nan Lin, Wei Zhang, Kaiying Zhang, Kun Peng, Dexiang Wang, Yan Zhao, Yuming Peng, Ruquan Han
BACKGROUND: Gabapentin is an adjuvant antiepileptic agent and helps to reduce acute postoperative pain in several surgery settings. However, the effect of gabapentin on postoperative pain from suboccipital or subtemporal craniotomy is not clear. METHODS: The study was a single-center, randomized, placebo-controlled, and double-blinded trial. A total of 122 patients undergoing elective craniotomy by a suboccipital or subtemporal approach were randomly allocated to a placebo group and gabapentin group...
August 21, 2018: Journal of Neurosurgical Anesthesiology
Martin Smith
No abstract text is available yet for this article.
October 2018: Journal of Neurosurgical Anesthesiology
Chittaranjan Andrade
No abstract text is available yet for this article.
October 2018: Journal of Neurosurgical Anesthesiology
Charles William Carspecken, Anna Borisovskaya, Shu-Tsui Lan, Katherine Heller, Jonathan Buchholz, David Ruskin, Irene Rozet
BACKGROUND: Although interest in ketamine use during electroconvulsive therapy (ECT) has increased, studies have been equivocal with regard to its efficacy. The aims of this clinical trial were to evaluate ketamine's antidepressive effects in ECT as a primary anesthetic, determine ketamine's tolerability when compared with standard anesthesia, and determine if plasma brain-derived neurotrophic factor (BDNF) is necessary for treatment response. MATERIALS AND METHODS: Adults meeting criteria for treatment-resistant depression undergoing index course ECT received either methohexital (1 to 2 mg/kg) or ketamine (1 to 2 mg/kg) anesthesia in this dual-arm double-blinded randomized clinical trial (NCT02752724)...
October 2018: Journal of Neurosurgical Anesthesiology
Veena Sheshadri, Lashmi Venkatraghavan, Pirjo Manninen, Mark Bernstein
Same day discharge or outpatient surgery for intracranial procedures has become possible with the advent of image-guided minimally invasive approaches to surgery and availability of short-acting anesthetic agents. In addition, patient satisfaction and the benefits of avoiding hospital stay have resulted in the evolution of neurosurgical day surgery. We reviewed our experience and the available literature to determine the perioperative factors involved which have promoted and will improve this concept in the future...
October 2018: Journal of Neurosurgical Anesthesiology
Andrew K Rock, Charles F Opalak, Kathryn G Workman, William C Broaddus
BACKGROUND: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) was used to establish predictors for 30-day postoperative complications following spine and cranial neurosurgery. MATERIALS AND METHODS: The ACS-NSQIP participant use files were queried for neurosurgical cases between 2005 and 2015. Prevalence of postoperative complications following neurosurgery was determined. Nested multivariable logistic regression analysis was used to identify demographic, comorbidity, and perioperative characteristics associated with any complication and mortality for spine and cranial surgery...
October 2018: Journal of Neurosurgical Anesthesiology
Wen-Ya Bai, Yan-Chao Yang, Xiu-Fei Teng, Yu-Xiao Wan, Wei Wei, Jun-Chao Zhu
BACKGROUND: Elderly patients have an increased risk of a stress response during extubation after general anesthesia. In this study, we aimed to investigate whether transcutaneous electrical acupoint stimulation (TEAS) might decrease the stress response and improve the quality of recovery in elderly patients after elective supratentorial craniotomy. MATERIALS AND METHODS: In this prospective randomized controlled study, patients were randomly assigned to either a TEAS group (n=37) or a control group (n=38)...
October 2018: Journal of Neurosurgical Anesthesiology
Woodrow W Wendling, Dong Chen, Karen S Wendling, Ihab R Kamel
This study examines the direct effects of 3 noncompetitive N-methyl-D-aspartate receptor antagonists, phencyclidine (PCP), (+)MK-801, and (-)MK-801, on bovine middle cerebral arteries (BMCA). Rings of BMCA were mounted in isolated tissue chambers equipped with isometric tension transducers to obtain pharmacologic dose-response curves. In the absence of endogenous vasoconstrictors, the 3 N-methyl-D-aspartate antagonists each produced direct constriction of BMCA. The thromboxane A2 receptor antagonist SQ-29,548, the TxA2 synthase inhibitor furegrelate, the calcium antagonist nimodipine, and calcium-deficient media all inhibited maximal phencyclidine or (+)MK-801-induced constriction...
October 2018: Journal of Neurosurgical Anesthesiology
John Cormack, Shravya Karna
No abstract text is available yet for this article.
October 2018: Journal of Neurosurgical Anesthesiology
Hakseung Kim, Seung-Bo Lee, Yunsik Son, Marek Czosnyka, Dong-Joo Kim
BACKGROUND: Hemodynamic instability and cardiovascular events heavily affect the prognosis of traumatic brain injury. Physiological signals are monitored to detect these events. However, the signals are often riddled with faulty readings, which jeopardize the reliability of the clinical parameters obtained from the signals. A machine-learning model for the elimination of artifactual events shows promising results for improving signal quality. However, the actual impact of the improvements on the performance of the clinical parameters after the elimination of the artifacts is not well studied...
October 2018: Journal of Neurosurgical Anesthesiology
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