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Neuro anesthesia

Gabriela Hernandez-Meza, Meltem Izzetoglu, Mary Osbakken, Michael Green, Hawa Abubakar, Kurtulus Izzetoglu
The American Society of Anesthesiologist recommends peripheral physiological monitoring during general anesthesia, which offers no information regarding the effects of anesthetics on the brain. Since no "gold standard" method exists for this evaluation, such a technique is needed to ensure patient comfort, procedure quality and safety. In this study we investigated functional near infrared spectroscopy (fNIRS) as possible monitor of anesthetic effects on the prefrontal cortex. Anesthetic drugs, such as sevoflurane, suppress the cerebral metabolism and alter the cerebral blood flow...
February 18, 2017: Journal of Clinical Monitoring and Computing
Susan M Goobie, Franklyn P Cladis, Chris D Glover, Henry Huang, Srijaya K Reddy, Allison M Fernandez, David Zurakowski, Paul A Stricker
BACKGROUND: Antifibrinolytic therapy significantly decreases blood loss and transfusion in pediatric cranial vault reconstructive surgery; however, concern regarding the side effects profile limits clinical use. AIMS: The aim was to utilize the Pediatric Craniofacial Surgery Perioperative Registry database to identify the safety profile of antifibrinolytic therapy for cranial vault reconstructive surgery by reporting the incidence of adverse events as they relate to exposure to tranexamic acid and aminocaproic acid compared to no exposure to antifibrinolytics...
March 2017: Paediatric Anaesthesia
De-An Zhao, Ling-Yun Bi, Qian Huang, Fang-Min Zhang, Zi-Ming Han
BACKGROUND AND OBJECTIVES: Isoflurane is halogenated volatile ether used for inhalational anesthesia. It is widely used in clinics as an inhalational anesthetic. Neonatal hypoxic ischemia injury ensues in the immature brain that results in delayed cell death via excitotoxicity and oxidative stress. Isoflurane has shown neuroprotective properties that make a beneficial basis of using isoflurane in both cell culture and animal models, including various models of brain injury. We aimed to determine the neuroprotective effect of isoflurane on hypoxic brain injury and elucidated the underlying mechanism...
November 2016: Brazilian Journal of Anesthesiology
Riva R Ko, Teeda Pinyavat, Steven Stylianos, Sarah M Lambert, Richard C Anderson, Pamela F Gallin, Lynne G Maxwell, Christopher G Ward, Jayant K Deshpande, Constance S Houck
The Pediatric Anesthesia Neuro Development Assessment (PANDA) team at the Anesthesiology Department at Columbia University Medical Center held its fifth biennial symposium to discuss issues regarding potential neurotoxicity of anesthetic agents in pediatric patients. Overall optimal surgical timing as well as a "critical window" for surgery on a specialty specific basis are areas of focus for the American Academy of Pediatrics Surgical Advisory Panel. An ad hoc panel of pediatric surgical experts representing general surgery, urology, neurosurgery, and ophthalmology was assembled for this meeting and provided a dialogue focused on the benefits of early intervention versus potential anesthetic risk, addressing parental concerns, and the need for continued interdisciplinary collaboration in this area...
October 2016: Journal of Neurosurgical Anesthesiology
De-An Zhao, Ling-Yun Bi, Qian Huang, Fang-Min Zhang, Zi-Ming Han
BACKGROUND AND OBJECTIVES: Isoflurane is halogenated volatile ether used for inhalational anesthesia. It is widely used in clinics as an inhalational anesthetic. Neonatal hypoxic ischemia injury ensues in the immature brain that results in delayed cell death via excitotoxicity and oxidative stress. Isoflurane has shown neuroprotective properties that make a beneficial basis of using isoflurane in both cell culture and animal models, including various models of brain injury. We aimed to determine the neuroprotective effect of isoflurane on hypoxic brain injury and elucidated the underlying mechanism...
September 13, 2016: Revista Brasileira de Anestesiologia
Faraz Shafiq, Muhammad Irfan Ul Haq
No abstract text is available yet for this article.
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Otto M Henriksen, Lisbeth Marner, Ian Law
The introduction of hybrid PET/MRI systems allows simultaneous multimodality image acquisition of high technical quality. This technique is well suited for the brain, and particularly in dementia and neuro-oncology. In routine use combinations of well-established MRI sequences and PET tracers provide the most optimal and clinically valuable protocols. For dementia the [18F]-fluorodeoxyglucose (FDG) has merit with a simultaneous four sequence MRI protocol of 20 min supported by supplementary statistical reading tools and quantitative measurements of the hippocampal volume...
October 2016: PET Clinics
Christiane Goeters, Hugo Van Aken
Rapid progress in medical science and technique offer new complex individual treatment modalities. Distinct profile qualifications like echocardiography, electroencephalography are required for anesthesia in high risk populations (cardiovascular, pediatric and neuro surgical patients) to guarantee best patient care and outcome. Accredited subspecialties and distinct fellowship programs are required to improve medical education, training and research.
July 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Stefan Josef Schaller, Heidrun Lewald
INTRODUCTION: Sugammadex is the first clinical representative of a class of drugs called steroidal muscle relaxant encapsulators. Due to its 1:1 binding of rocuronium or vecuronium, sugammadex can reverse any depth of neuromuscular block and has therefore revolutionized the way anesthetists think about drug reversal. AREAS COVERED: This review gives an overview of the clinical pharmacology and efficacy of sugammadex in healthy patients as well as in patients with pre-existing diseases...
September 2016: Expert Opinion on Drug Metabolism & Toxicology
A H Shruthi, S S Nethra, K Sudheesh, D Devika Rani, R S Raghavendra Rao
BACKGROUND: Extubation is known to produce significant hemodynamic disturbances. There is a need to avoid increase in heart rate and blood pressure in hypertensive and cardiac patients and in vascular, neuro and intraocular surgeries. AIMS: To study the ability of dexmedetomidine to attenuate the hemodynamic responses during extubation. MATERIALS AND METHODS: 80 patients of ASA Grade I-II aged 18-50 years received standard anesthesia. At the closure of skin incision, patients were randomly allocated to receive either dexmedetomidine 0...
February 2016: Middle East Journal of Anesthesiology
Maria Vaz Antunes, Adriano Moreira, Catarina Sampaio, Aida Faria
INTRODUCTION: Accidental dural puncture is an important complication of regional anesthesia and post-dural puncture headache remains a disable outcome in obstetric population. The aim of our study was to calculate the incidence of accidental puncture and post-puncture headache and evaluate its management among obstetric anesthesiologists. MATERIAL AND METHODS: We conducted a retrospective audit, between January 2007 and December 2014. We reviewed the record sheets of patients who experienced either accidental puncture or post-puncture headache...
April 2016: Acta Médica Portuguesa
S Ozcan, A B Ozer, M A Yasar, O L Erhan
BACKGROUND: Severe postoperative pain is not often experienced in laparoscopic cholecystectomy. Anesthesia, surgery, and pain are stressful and cause different reactions in neuro-immuno-endocrine systems. Many factors such as the pharmacological effect of the drugs used, as well as the type and depth of anesthesia, can affect these reactions. OBJECTIVE: The aim of this study was to evaluate the effect of the combination of general anesthesia and thoracic epidural analgesia (TEA) on cytokine reaction in laparoscopic cholecystectomy...
July 2016: Nigerian Journal of Clinical Practice
Hironori Tsuchiya
Clinicians often experience the reduced efficacy of general and local anesthetics and anesthesia-related drugs in habitual drinkers and chronic alcoholics. However, the mechanistic background underlying such anesthetic tolerance remains unclear. Biogenic indoleamines condense with alcohol-derived aldehydes during fermentation processes and under physiological conditions to produce neuro-active tetrahydro-β-carbolines and β-carbolines, many of which are contained not only in various alcoholic beverages but also in human tissues and body fluids...
July 2016: Medical Hypotheses
Xiaochun Zheng, Feng Chen, Ting Zheng, Fengyi Huang, Jianghu Chen, Wenshao Tu
Tricyclic antidepressant amitriptyline (AM) has been shown to exert neurotrophic activity on neurons. We thus explored whether AM may aid the neuronal development and protect anesthesia-induced neuro-injury in young spinal cord dorsal root ganglion (DRG) neurons.The DRG explants were prepared from 1-day-old rats. The effect of AM on aiding DRG neural development was examined by immunohistochemistry at dose-dependent manner. AM-induced changes in gene and protein expressions, and also phosphorylation states of tyrosine kinases receptor A (TrkA) and B (TrkB) in DRG, were examined by quantitative real-time polymerase chain reaction and western blot...
May 2016: Medicine (Baltimore)
Bing-Xin Xiao, Li Feng, Fang-Rui Cao, Rui-Le Pan, Yong-Hong Liao, Xin-Min Liu, Qi Chang
ETHNOPHARMACOLOGICAL RELEVANCE: Traditional Chinese medicine Radix Puerariae, the roots of Pueraria lobata (Wild.) Ohwi., has been widely used for the treatment of cardiovascular and cerebrovascular diseases in China for centuries. Isoflavonoids are believed the active components of this herb. AIM OF THIS STUDY: The present study aims to investigate the brain penetration and pharmacokinetics of five active isoflavonoids in the ventricular CSF and plasma of rats after intravenous administration of a Pueraria isoflavonoids (PIF) extract, to better understand the active components of this herb for neuro-activities...
May 26, 2016: Journal of Ethnopharmacology
R Aaron Bola, Eugene A Kiyatkin
Glucose is the main energetic substrate for the metabolic activity of brain cells and its proper delivery into the extracellular space is essential for maintaining normal neural functions. Under physiological conditions, glucose continuously enters the extracellular space from arterial blood via gradient-dependent facilitated diffusion governed by the GLUT-1 transporters. Due to this gradient-dependent mechanism, glucose levels rise in the brain after consumption of glucose-containing foods and drinks. Glucose entry is also accelerated due to local neuronal activation and neuro-vascular coupling, resulting in transient hyperglycemia to prevent any metabolic deficit...
2016: Frontiers in Physiology
Marian Feil, Nicole A Irick
As neurosurgical interventions and procedures are advancing, so is the specialty of neuro-anesthesia. The neurosurgeon and the neuro-anesthetist are focused on providing each patient with the best possible outcome. Throughout the surgery, the main priorities of the neuro-anesthetist are patient safety, patient well-being, surgical field exposure, and patient positioning. Potential postoperative complications include nausea and vomiting. Postoperative visual loss is a complication of neurosurgery, most specifically spine surgery, whose origins are unknown...
March 2016: Critical Care Nursing Clinics of North America
Javed Khader Eliyas, Ryan Glynn, Charles G Kulwin, Richard Rovin, Ronald Young, Juan Alzate, Gustavo Pradilla, Mitesh V Shah, Amin Kassam, Ivan Ciric, Julian Bailes
BACKGROUND: Conventional approaches to deep-seated cerebral lesions range from biopsy to transcortical or transcallosal resection. Although the former does not reduce tumor burden, the latter are more invasive and associated with greater potential for irreparable injury to normal brain. Disconnection syndrome, hemiparesis, hemianesthesia, or aphasia is not uncommon after such surgery, especially when lesion is large. By contrast, the transsulcal parafascicular approach uses naturally existing corridors and a tubular retractor to minimize brain injury...
June 2016: World Neurosurgery
Tumul Chowdhury, Nitin Ahuja, Bernhard Schaller
Hemodynamic alterations are observed in various neurosurgical procedures and commonly related to different neurogenic mechanisms. However, anesthetic influences on causation of these perturbations or management are rarely investigated and therefore our present knowledge is still limited.In this case of 43-old Caucasian male, propofol boluses aborted the trigeminal cardiac reflex (TCR) induced severe bradycardia during dural manipulation. There is a correlation of severity of bradycardia and slightness of anesthesia...
December 2015: Medicine (Baltimore)
Pradeep Tyagi, Katsumi Kadekawa, Mahendra Kashyap, Subrata Pore, Naoki Yoshimura
OBJECTIVE: To investigate the time-dependent changes in expression of cytokines that characterizes the spontaneous recovery of reflex voiding after spinal cord injury (SCI). SCI is known to reorganize the neural circuitry of micturition reflex after injury. METHODS: Under isoflurane anesthesia, spinal cord of 18 adult female Sprague-Dawley rats was completely transected at the Th9-10 level. Awake cystometry was performed at each time point on controls and 6 SCI animals, and bladder was then harvested for analysis of 29 proteins Millipore kit or enzyme-linked immunosorbent assay...
February 2016: Urology
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