lidocaine in neuroanesthesia

STUDY DESIGN: Expert opinion-modified Delphi study. OBJECTIVE: We used a modified Delphi approach to obtain consensus among leading spinal deformity surgeons and their neuroanesthesiology teams regarding optimal practices for obtaining reliable motor evoked potential (MEP) signals. SUMMARY OF BACKGROUND DATA: Intraoperative neurophysiological monitoring of transcranial MEPs provides the best method for assessing spinal cord integrity during complex spinal surgeries...

PURPOSE: Postcraniotomy headache (PCH) is a frequent perioperative complication in neuroanesthesia. The aim of the present work was to assess the incidence of PCH and to test the efficacy and safety of preoperatively administered diclofenac. METHODS: Patients undergoing craniotomies for intracranial tumor resections were enrolled. In the case group 100 mg diclofenac p.o. one hour prior to surgery was used as a preemptive analgesic along with infiltration of the surgical site with a combination of lidocaine and epinephrine...

OBJECTIVE: To assess the current practices in anaesthesia and intensive care in patients experiencing subarachnoid haemorrhage (SAH). STUDY DESIGN: Analysis of questionnaire sent to the members of the French speaking Association of neuroanesthesia and intensive care. METHODS: The survey, performed in the summer of 1995, included questions on the composition of the neuroanesthesia team, anaesthesia, as well as medical and surgical treatments...

Bolus injections of lidocaine are commonly used during neuroanesthesia to prevent or treat ICP elevations caused by tracheal or painful stimuli. Lidocaine can also be employed in case of hard intracranial hypertension, when the usual therapy fails. With continuous perfusion, at high doses, of this agent, a state of lidocaine anesthesia can be induced which is more readily reversible than barbiturate anesthesia. A simultaneous anticonvulsant therapy is mandatory because of the well-known epileptogenicity of lidocaine...

Since Althesin was withdrawn from the market, and since Ledingham's report on the inhibitory effect of etomidate on cortisol secretion, anaesthesia in intracranial surgery has lacked an intravenous agent with a pharmacokinetic-dynamic profile making it a suitable alternative to the classic thiopental-isoflurane sequence. Propofol has been used experimentally in neuroanaesthesia for 4 years, and is now ready to be used on a routine basis in neuroanaesthesia. An induction dose of propofol decreases cerebral blood flow (CBF), cerebral metabolic rate for oxygen (CMR02), and intracranial pressure (ICP)...