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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
Adnan I Qureshi, Nishath Naseem, Muhammad A Saleem, Shawn S Wallery, Faisal Raja
No abstract text is available yet for this article.
July 17, 2018: Journal of Neurosurgical Anesthesiology
Claudius Doerr, Clemens Kietaibl, Katharina Doerr, Michael Hagmann, Lukas Baumann, Oliver Kimberger, Roman Ullrich, Klaus Markstaller, Klaus U Klein
BACKGROUND: Critically ill patients with acute respiratory failure admitted to an intensive care unit are at high risk for cerebral hypoxia. We investigated the impact of continuous positive airway pressure (CPAP) therapy on regional cerebral tissue oxygenation (rSO2). MATERIALS AND METHODS: In total, 40 extubated surgical intensive care unit patients requiring classic oxygen therapy (COT) for acute respiratory failure were examined. Near-infrared spectroscopy (INVOS 5100C, Covidien) was used for 30 minutes to detect bilateral rSO2 during COT via facemask (6 L/min) and CPAP therapy (40% fraction of inspired oxygen, 8 cm H2O CPAP) using a randomized crossover study design...
July 13, 2018: Journal of Neurosurgical Anesthesiology
Vlasta Dostalova, David Astapenko, Vlasta Dostalova, Jaroslav Kraus, Vladimir Cerny, Alena Ticha, Radomir Hyspler, Vera Radochova, Jiri Paral, Pavel Dostal
BACKGROUND: Fluid loading and hyperosmolar solutions can modify the cortical brain microcirculation and the endothelial glycocalyx (EG). This study compared the short-term effects of liberal fluid loading with a restrictive fluid intake followed by osmotherapy with hypertonic saline (HTS) on cerebral cortical microcirculation and EG integrity in a rabbit craniotomy model. METHODS: The experimental rabbits were allocated randomly to receive either <2 mL/kg/h (group R, n=14) or 30 mL/kg/h (group L, n=14) of balanced isotonic fluids for 1 hour...
July 13, 2018: Journal of Neurosurgical Anesthesiology
Thibaud Crespy, Magali Heintzelmann, Celia Chiron, Marc Vinclair, Florence Tahon, Gilles Francony, Jean-François Payen
BACKGROUND: Milrinone has emerged as an option to treat delayed cerebral ischemia after subarachnoid hemorrhage. However, substantial variation exists in the administration of this drug. We retrospectively assessed the effectiveness of 2 protocols in patients with angiographically proven cerebral vasospasm. METHODS: During 2 successive periods, milrinone was administered using either a combination of intra-arterial milrinone infusion followed by intravenous administration until day 14 after initial bleeding (IA+IV protocol), or a continuous intravenous milrinone infusion for at least 7 days (IV protocol)...
July 13, 2018: Journal of Neurosurgical Anesthesiology
Andrey Khozhenko, Massimo Lamperti, Sergio Terracina, Federico Bilotta
Cerebral near-infrared spectroscopy (NIRS) is considered a valuable noninvasive modality for cerebral oxygenation monitoring during cardiovascular surgery and cardiac arrest. We assessed the capability of cerebral NIRS to predict cerebral desaturation and the related neurological outcomes in neurosurgical patients. A literature search in different electronic medical databases was performed from inception to January 2018. A total of 286 citations were found and finally 48 studies were retrieved, only 7 of these were eligible and included for review...
July 11, 2018: Journal of Neurosurgical Anesthesiology
Kiran Bharath Venkatesulu, Amar Nandhakumar, Mathew Cherian, Pankaj Mehta, Sriram Kalingarayar, Sharmila Shanmugam
No abstract text is available yet for this article.
June 29, 2018: Journal of Neurosurgical Anesthesiology
Swati Singh, Neeraj K Chaudhary
No abstract text is available yet for this article.
June 29, 2018: Journal of Neurosurgical Anesthesiology
Weiliang Zhang, Jonathan Neal, Liang Lin, Feng Dai, Denise P Hersey, David L McDonagh, Fan Su, Lingzhong Meng
OBJECTIVE: Despite clinical use spanning 50+ years, questions remain concerning the optimal use of mannitol. The published reviews with meta-analysis frequently focused on mannitol's effects on a specific physiological aspect such as intracranial pressure (ICP) in sometimes heterogeneous patient populations. A comprehensive review of mannitol's effects, as well as side effects, is needed. METHODS: The databases Medline (OvidSP), Embase (OvidSP), and NLM PubMed were systematically searched for randomized controlled trials (RCTs) comparing mannitol to a control therapy in either the critical care or perioperative setting...
June 26, 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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