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Neurosurgical anesthesia

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https://www.readbyqxmd.com/read/29628584/evaluation-of-the-hemodynamic-response-of-intravenous-clonidine-versus-ropivacaine-scalp-block-to-insertion-of-scalp-pins-in-neurosurgical-patients
#1
Saraswathi Nagappa, Sandhya Kalappa, Raghavendra Biligiri Sridhara
Background: The application of the skull-pin head-holder, used to stabilize the head during neurosurgical procedures, produces an intense nociceptive stimulus and results in abrupt increases in blood pressure and cerebral blood flow under general anesthesia. Different anesthetic and pharmacologic techniques, including local anesthetics, narcotics, antihypertensives, and deepening of anesthesia with inhalation anesthetics, have been used to blunt this deleterious effect with variable success...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29620662/good-outcomes-after-the-delayed-removal-of-an-epidural-hematoma-a-case-report
#2
Yong-Xing Yao, Ming-Xia Li, Lian-Juan Sun
RATIONALE: Epidural hematomas can develop following intrathecal puncture, spinal vascular malformation, or spontaneous hemorrhage. Prompt recognition of symptoms and referral to neurosurgical services are crucial for recovery. We report a rare case of delayed removal of an epidural hematoma that resulted in good patient outcomes. PATIENT CONCERNS: A 69-year-old woman weighing 58 kg presented with back pain that had persisted for 12 years. Her medical history was notable for hypertension...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29611200/assessment-of-pre-operative-maropitant-citrate-use-in-macaque-macaca-fasicularis-macaca-mulatta-neurosurgical-procedures
#3
Jaclyn R Steinbach, Jamus MacGuire, Shu Chang, Elizabeth Dierks, Gordon S Roble
BACKGROUND: Retrospective analysis of post-operative vomiting (POV) in non-human primates at our institution was 11%. Based on this additional risk factor for post-operative complications, we aimed to eliminate or decrease POV by adding an antiemetic, maropitant citrate, to the pre-medication protocol. METHODS: Retrospective and prospective data were collected over a 5-year period from 46 macaques of two species during 155 procedures. Additionally, blood was collected from five Macaca mulatta to perform a pharmacokinetic analysis...
April 2, 2018: Journal of Medical Primatology
https://www.readbyqxmd.com/read/29470316/protecting-the-brain-with-xenon-anesthesia-for-neurosurgical-procedures
#4
Anna Rylova, Mervyn Maze
Xenon possesses some, but not all, of the clinical features of an ideal anesthetic agent. Besides well-known advantages of rapid awakening, stable hemodynamics and lack of biotransformation, preclinical data lead to the expectation of xenon's advantageous use for settings of acute ongoing brain injury; a single randomized clinical trial using an imaging biomarker for assessing brain injury corroborated xenon's preclinical efficacy in protecting the brain from further injury. In this review, we discuss the mechanisms and hence the putative applications of xenon for brain protection in neurosurgery...
February 21, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29456901/awake-craniotomy-for-the-treatment-of-a-cortical-pseudoaneurysm-in-a-pregnant-patient
#5
Hirad Hedayat, Daniel R Felbaum, John E Reynolds, Rashid M Janjua
Neurosurgical pathologies presenting during pregnancy are uncommon. If present, the situation creates a unique diagnostic, observational, and therapeutic challenge as both lives are placed at potential risk. Surgical procedures during pregnancy are approached carefully as physiological stressors associated with surgery and anesthesia may cause fetal or maternal compromise. We present the only known case of a pseudoaneurysm treated with an awake craniotomy, allowing us to abate the risks associated with general anesthesia in pregnancy...
December 7, 2017: Curēus
https://www.readbyqxmd.com/read/29444286/techniques-to-ensure-accurate-targeting-for-delivery-of-awake-laser-interstitial-thermotherapy
#6
Dimitri Laurent, Seth F Oliveria, Michael Shang, Frank Bova, Rachel Freedman, Maryam Rahman
BACKGROUND: Magnetic resonance imaging (MRI) guided laser interstitial thermal therapy (LITT) is an emerging neurosurgical treatment modality that is typically performed under general anesthesia. We describe a novel workflow developed at the University of Florida to deliver LITT in conscious patients without the use of general anesthesia. OBJECTIVE: To describe a novel workflow for LITT implementation in the awake patient with equivalent treatment results when compared to procedures performed under general anesthesia...
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29440926/local-anesthetics-for-brain-tumor-resection-current-perspectives
#7
REVIEW
Jan-Willem Potters, Markus Klimek
This review summarizes the added value of local anesthetics in patients undergoing craniotomy for brain tumor resection, which is a procedure that is carried out frequently in neurosurgical practice. The procedure can be carried out under general anesthesia, sedation with local anesthesia or under local anesthesia only. Literature shows a large variation in the postoperative pain intensity ranging from no postoperative analgesia requirement in two-thirds of the patients up to a rate of 96% of the patients suffering from severe postoperative pain...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29424629/parental-satisfaction-with-being-present-in-the-operating-room-during-the-induction-of-anesthesia-prior-to-pediatric-neurosurgical-intervention-a-qualitative-analysis
#8
Hena Waseem, Rachael S Mazzamurro, Alec H Fisher, Subasish Bhowmik, Rifat A Zaman, Angeline Andrew, David F Bauer
OBJECTIVE Parental presence in the operating room during the induction of anesthesia (PPIA) has been shown to decrease parent and child anxiety and increase satisfaction with patient experience in outpatient otolaryngological procedures, such as tympanostomy tube placement. PPIA for other procedures, such as a major neurosurgical intervention, has been a practice at the authors' institutions for many years. This practice is not universally accepted across the United States, and the potential benefits for patients and families have not been formally evaluated...
February 9, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29394907/the-effect-of-an-intraoperative-lung-protective-ventilation-strategy-in-neurosurgical-patients-undergoing-craniotomy-study-protocol-for-a-randomized-controlled-trial
#9
Liyong Zhang, Wei Xiong, Yuming Peng, Wei Zhang, Ruquan Han
BACKGROUND: Ventilator-induced lung injury is a major cause of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgery after general anesthesia. However, there is no study on the effect of a lung-protective ventilation strategy in patients undergoing neurosurgery. METHODS: This is a single-center, randomized, parallel-group controlled trial which will be carried out at Beijing Tiantan Hospital, Capital Medical University. Three hundred and thirty-four patients undergoing intracranial tumor surgery will be randomly allocated to the control group and the protective-ventilation strategy group...
February 2, 2018: Trials
https://www.readbyqxmd.com/read/29315660/precision-and-bias-of-target-controlled-prolonged-propofol-infusion-for-general-anesthesia-and-sedation-in-neurosurgical-patients
#10
Andrea Cortegiani, Alessandra Pavan, Fabio Azzeri, Giuseppe Accurso, Filippo Vitale, Cesare Gregoretti
The aim of this study was to determine the relationship, precision, and bias of a propofol target-controlled infusion (TCI) system during prolonged infusion in neurosurgical patients. We retrospectively included patients undergoing general anesthesia for elective neurosurgical removal of brain tumors and postoperative sedation in the intensive care unit over a period of 3 months. TCI of propofol (Diprifusor - Marsh model) and remifentanil were used for general anesthesia and sedation. We compared propofol blood concentration (Cmeas ) measured by liquid chromatography-mass spectroscopy with predicted concentrations (Cpred ) by the TCI system at 40 minutes (T0), 2 hours (T1), and 4 hours (T2) and every 8 hours after starting the drug infusion and at the time of emergence from sedation...
January 9, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29309289/anesthesia-for-same-day-discharge-after-craniotomy-review-of-a-single-center-experience
#11
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...
January 5, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29288841/management-of-severe-traumatic-brain-injury-first-24hours
#12
Thomas Geeraerts, Lionel Velly, Lamine Abdennour, Karim Asehnoune, Gérard Audibert, Pierre Bouzat, Nicolas Bruder, Romain Carrillon, Vincent Cottenceau, François Cotton, Sonia Courtil-Teyssedre, Claire Dahyot-Fizelier, Frédéric Dailler, Jean-Stéphane David, Nicolas Engrand, Dominique Fletcher, Gilles Francony, Laurent Gergelé, Carole Ichai, Étienne Javouhey, Pierre-Etienne Leblanc, Thomas Lieutaud, Philippe Meyer, Sébastien Mirek, Gilles Orliaguet, François Proust, Hervé Quintard, Catherine Ract, Mohamed Srairi, Karim Tazarourte, Bernard Vigué, Jean-François Payen
The latest French Guidelines for the management in the first 24hours of patients with severe traumatic brain injury (TBI) were published in 1998. Due to recent changes (intracerebral monitoring, cerebral perfusion pressure management, treatment of raised intracranial pressure), an update was required. Our objective has been to specify the significant developments since 1998. These guidelines were conducted by a group of experts for the French Society of Anesthesia and Intensive Care Medicine (Société francaise d'anesthésie et de réanimation [SFAR]) in partnership with the Association de neuro-anesthésie-réanimation de langue française (ANARLF), The French Society of Emergency Medicine (Société française de médecine d'urgence (SFMU), the Société française de neurochirurgie (SFN), the Groupe francophone de réanimation et d'urgences pédiatriques (GFRUP) and the Association des anesthésistes-réanimateurs pédiatriques d'expression française (ADARPEF)...
April 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29285407/designing-a-pain-management-protocol-for-craniotomy-a-narrative-review-and-consideration-of-promising-practices
#13
REVIEW
Susana Vacas, Barbara Van de Wiele
Background: Craniotomy is a relatively common surgical procedure with a high incidence of postoperative pain. Development of standardized pain management and enhanced recovery after surgery (ERAS) protocols are necessary and crucial to optimize outcomes and patient satisfaction and reduce health care costs. Methods: This work is based upon a literature search of published manuscripts (between 1996 and 2017) from Pubmed, Cochrane Central Register, and Google Scholar...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29273384/surgical-technique
#14
REVIEW
Marc Guénot, Axel Lebas, Bertrand Devaux, Sophie Colnat-Coulbois, Georg Dorfmuller, Aileen McGonigal, Nicolas Reyns, Vianney Gilard, Stéphane Derrey, Jean-Christophe Sol, Stéphane Clémenceau
In SEEG, as for any surgical procedure, the benefit/risk ratio is a key-point. This implies rigorous clinical practice in terms of indication, information delivered to the patient, and surgical technique. Numerous technical options may be used to achieve this goal. All are valuable, as long as they are executed with rigor and consistency. Intracranial bleeding represents the main risk of the procedure (1-4% of cases). The procedure also carries a risk of infection (0.8%), death (total of 6 reported cases in all the literature, <0...
February 2018: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/29243977/factors-predicting-reoperation-of-chronic-subdural-hematoma-following-primary-surgical-evacuation
#15
Rouzbeh Motiei-Langroudi, Martina Stippler, Siyu Shi, Nimer Adeeb, Raghav Gupta, Christoph J Griessenauer, Efstathios Papavassiliou, Ekkehard M Kasper, Jeffrey Arle, Ron L Alterman, Christopher S Ogilvy, Ajith J Thomas
OBJECTIVE Chronic subdural hematoma (CSDH) is commonly encountered in neurosurgical practice. However, surgical evacuation remains complicated by a high rate of reoperation. The optimal surgical approach to reduce the reoperation rate has not been determined. In the current study, the authors evaluated the prognostic value of clinical and radiographic factors to predict reoperation in the context of CSDH. METHODS A retrospective review of 325 CSDH patients admitted to an academic medical center in the United States, between 2006 and 2016, was performed...
December 15, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29241172/neurophysiological-monitoring-and-awake-craniotomy-for-resection-of-intracranial-gliomas
#16
Taiichi Saito, Manabu Tamura, Mikhail F Chernov, Soko Ikuta, Yoshihiro Muragaki, Takashi Maruyama
Aggressive resection of intracranial gliomas has a positive impact on patients' prognosis, but is associated with a risk of neurological complications. For preservation of brain functions and avoidance of major postoperative morbidity various methods of intraoperative neurophysiological monitoring have been introduced into clinical practice. At present, somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), visual evoked potentials (VEP), brainstem auditory evoked potentials (BAEP), and electrocorticography (ECoG) are used routinely during neurosurgical procedures...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29229347/postoperative-stridor-and-acute-respiratory-failure-after-parkinson-disease-deep-brain-stimulator-placement-case-report-and-review-of-literature
#17
Mi Wang, Wael Saasouh, Thomas Botsford, Allen Keebler, Andrew Zura, Michael S Benninger, Rafi Avitsian
BACKGROUND: Parkinson disease (PD), a neurodegenerative disorder characterized by loss of dopaminergic neurons in the substantia nigra of the midbrain, is commonly thought of as a motion disorder, but it can have significant effect on the respiratory system. Respiratory failure is the most common cause of death in these patients, but it can also affect laryngeal function causing dysphonia, dysphagia, and dysarthric speech. Acute upper airway obstruction is a rare finding in PD, especially in the perioperative settings...
March 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29226114/comparison-the-effects-of-intraoperative-labetalol-and-lidocaine-on-postoperative-blood-pressure-and-heart-rate-in-brain-surgeries
#18
Mohammadali Attari, Behrooz Ziai, Ahmad Raeisi
Background: Long-term anesthesia applied in some operations, especially in neurosurgical operations leads to unwanted complications. This study aimed to compare the effect of intraoperative labetalol and lidocaine injection on the rate of changes in postoperative blood pressure and heart beat in patients undergoing brain operation. Materials and Methods: This is a simple double-blind randomized clinical trial study conducted in Al-Zahra and Kashani Hospitals on 90 patients' candidate for craniotomy operation with the age range of 18-65 years, Glasgow Coma Scale (GCS) ≥13 before anesthesia, physical class of American Society of Anesthesiologists I, II, insensitivity to labetalol who were divided into two groups of 45 individuals in the random allocation method...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29155706/comprehensive-endovascular-and-open-surgical-management-of-cerebral-arteriovenous-malformations
#19
Robert C Rennert, Jeffrey A Steinberg, Vincent J Cheung, David R Santiago-Dieppa, Jeffrey Scott Pannell, Alexander A Khalessi
Arteriovenious malformations (AVMs) are associated with significant morbidity and mortality, and have a rupture risk of ~3% per year. Treatment of AVMs must be tailored specifically to the lesion, with surgical resection being the gold standard for small, accessible lesions. Pre-operative embolization of AVMs can reduce nidal blood flow and remove high-risk AVM features such as intranidal or venous aneurysms, thereby simplifying a challenging neurosurgical procedure. Herein, we describe our approach for the staged endovascular embolization and open resection of AVMs, and highlight the advantages of having a comprehensively trained neurovascular surgeon leading a multi-disciplinary clinical team...
October 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29122534/influence-of-antithrombotic-agents-on-recurrence-rate-and-clinical-outcome-in-patients-operated-for-chronic-subdural-hematoma
#20
Tammam Abboud, Lasse Dührsen, Christina Gibbert, Manfred Westphal, Tobias Martens
INTRODUCTION: Chronic subdural hematoma (cSDH) is a common pathology encountered in neurosurgical practice, especially in elderly patients, who frequently require antithrombotic agents. The aim of this study was to investigate the influence of antithrombotic agents on recurrence rates and clinical outcomes in patients operated for cSDH. METHODS: A cohort of patients operated for cSDH at one center during a 5 years period was analyzed retrospectively. Presenting symptoms, coagulation testing, history of antithrombotic agents and comorbidities were obtained from the patient charts...
November 6, 2017: Neurocirugía
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