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Neurosurgical anaesthesia

P Schramm, I Tzanova, F Hagen, M Berres, D Closhen, G Pestel, K Engelhard
BACKGROUND: Neurosurgical operations in the dorsal cranium often require the patient to be positioned in a sitting position. This can be associated with decreased cardiac output and cerebral hypoperfusion, and possibly, inadequate cerebral oxygenation. In the present study, cerebral oxygen saturation was measured during neurosurgery in the sitting position and correlated with cardiac output. METHODS: Perioperative cerebral oxygen saturation was measured continuously with two different monitors, INVOS(®) and FORE-SIGHT(®)...
October 2016: British Journal of Anaesthesia
Romuald Seizeur, Francis Abed-Rabbo, Sami Obaid, Philippe Saliou, Alexandre Simon, Phong Dam Hieu, Elsa Magro
OBJECTIVE: Chronic subdural haematomas (CSDH) is a common pathology that usually affects the elderly population. The incidence of CSDH has recently been increasing with the expansion of the aging population. The objective of our study was to evaluate the outcome following surgical drainage of CSDH in elderly patients. MATERIALS AND METHODS: We performed a retrospective analysis of 455 consecutive patients with CSDHs over a 5-year period. Among them, all 121 patients older than 80-year old were included in the study...
September 29, 2016: British Journal of Neurosurgery
Hemanshu Prabhakar, Gyaninder Pal Singh, Charu Mahajan, Indu Kapoor, Mani Kalaivani, Vidhu Anand
BACKGROUND: Brain tumour surgery usually is carried out with the patient under general anaesthesia. Over past years, both intravenous and inhalational anaesthetic agents have been used, but the superiority of one agent over the other is a topic of ongoing debate. Early and rapid emergence from anaesthesia is desirable for most neurosurgical patients. With the availability of newer intravenous and inhalational anaesthetic agents, all of which have inherent advantages and disadvantages, we remain uncertain as to which technique may result in more rapid early recovery from anaesthesia...
September 9, 2016: Cochrane Database of Systematic Reviews
Joji Inamasu, Shunsuke Nakae, Tatsuo Ohmi, Hirotaka Kogame, Yushi Kawazoe, Tadashi Kumai, Riki Tanaka, Akira Wakako, Kiyonori Kuwahara, Tsukasa Ganaha, Yuichi Hirose
Grade V subarachnoid haemorrhage (SAH) patients may be dichotomised into those with temporary deterioration and those with irreversible injury, and only the former have a chance of favourable outcomes by aneurysm obliteration. One method of differentiating the two conditions is to wait and observe potential recovery for 12-48hours. However, early rebleeding and non-convulsive seizures may occur during this period. In our institution, grade V SAH patients receive immediate treatment (general anaesthesia induction and aneurysm obliteration within 24hours of onset) to minimise those risks...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Rakesh Sethi, Imtiaz A Naqash, Sukhminder Jit Singh Bajwa, Vikas Dutta, Altaf Umar Ramzan, Syed Amir Zahoor
BACKGROUND AND AIM: The glucocorticoid dexamethasone in a bolus dose of 8-10 mg followed by quarterly dose of 4 mg is commonly used during intracranial surgery so as to reduce oedema and vascular permeability. However, the detrimental hyperglycaemic effects of dexamethasone may override its potentially beneficial effects. The present prospective, randomised study aimed at comparing the degree and magnitude of hyperglycaemia induced by prophylactic administration of dexamethasone in patients undergoing elective craniotomy...
April 2016: Asian Journal of Neurosurgery
Agnes S Meidert, Alexander Lang, Georg Hennig, Patricia Bernasconi, Aurelia Peraud, Josef Briegel, Tanija K Hüttl
An 8-year-old boy suffering from progressive glioblastoma was scheduled for neurosurgery. Prior to induction of anaesthesia pulse oximetry measured 64 % saturation of oxygen (SpO2). Arterial blood gas analysis revealed normal oxygen saturation and normal oxygen partial pressure. After having ruled out technical problems of pulse oximetry the neurosurgical procedure was halted. Meticulous examination of the child's history and medication did not explain a possible interaction of drugs with pulse oximetry. A Chinese herb tea had been given to the child, but was then stopped on the day of admission...
March 25, 2016: Journal of Clinical Monitoring and Computing
Robert Huhle, Joachim Siegert, Fred Wonka, Christoph Schindler, Marcelo Gama de Abreu, Thea Koch, Ute Morgenstern, Herman Theilen
OBJECTIVE: To assess the eligibility for replacement of invasive blood pressure as measured "within" the arterial vessel (IBP) with non-invasive continuous arterial blood pressure (cNIP) monitoring during total intravenous anaesthesia (TIVA), the ability of cNiP to track fast blood pressure changes needs to be quantified. A new method of statistical data analysis is developed for this purpose. METHODS: In a pilot study on patients undergoing neurosurgical anaesthesia, mean arterial pressure MAPIBP measured with IBP was compared to MAPCNP measured by the CNAP Monitor 500 in ten patients (age: 63±13 a)...
June 1, 2016: Biomedizinische Technik. Biomedical Engineering
I Phang, R Sivakumaran, M C Papadopoulos
INTRODUCTION: Neurosurgical trainees should achieve competency in chronic subdural haematoma (CSDH) drainage at an early stage in training. The effect of surgeon seniority on recurrence following surgical drainage of CSDH was examined. METHODS: All CSDH cases performed at St George's Hospital in London between March 2009 and March 2012 were analysed. Recurrence was defined as clinical deterioration with computed tomography evidence of CSDH requiring reoperation within six months...
November 2015: Annals of the Royal College of Surgeons of England
Priyanka Gupta, Girija Prasad Rath, Hemanshu Prabhakar, Parmod Kumar Bithal
BACKGROUND AND AIMS: Rapid recovery is desirable after neurosurgery as it enables early post-operative neurological evaluation and prompt management of complications. Studies have been rare comparing the recovery characteristics in paediatric neurosurgical patients. Hence, this study was carried out to compare the effect of sevoflurane and desflurane anaesthesia on emergence and extubation in children undergoing spinal surgery. METHODS: Sixty children, aged 1-12 years, undergoing elective surgery for lumbo-sacral spinal dysraphism were enrolled...
August 2015: Indian Journal of Anaesthesia
Abdul Ahad, Mohammed Elsayed, Hassaan Tohid
A large number of patients do not have cauda equina syndrome (CES) on MRI to account for their clinical findings; consequently, the majority of urgent scans requested are normal. We aimed to determine whether any clinical manifestation of CES, as stated in Royal College of Radiology guidelines, could predict the presence of established CES on MRI. We also aimed to support a larger study to develop a more universal assessment tool for acute lower back pain.A retrospective analysis of consecutive patients who warranted urgent MRI was conducted...
August 2015: Neuroradiology Journal
M Mahmoud, K P Mason
Despite lack of paediatric labelling, contributions to the literature on paediatric applications of dexmedetomidine have increased over recent years. Dexmedetomidine possesses many properties that are advantageous for a sedative and anaesthetic; it has been reported to provide sedation that parallels natural sleep, anxiolysis, analgesia, sympatholysis, and an anaesthetic-sparing effect with minimal respiratory depression. In addition, there is increasing evidence supporting its organ-protective effects against ischaemic and hypoxic injury...
August 2015: British Journal of Anaesthesia
Michel Wager, Philippe Rigoard, Benoit Bataille, Claude Guenot, Aurélie Supiot, Jean-Luc Blanc, Veronique Stal, Claudette Pluchon, Coline Bouyer, Roger Gil, Foucaud Du Boisgueheneuc
OBJECTIVE: Many neurosurgical procedures are now performed with the patient aware in order to allow interactions between the patient and healthcare professionals. These procedures include awake brain surgery and spinal cord stimulation (SCS), lead placement for treatment of refractory chronic back and leg pain. Neurosurgical procedures under local anaesthesia require optimal intraoperative cooperation of the patient and all personnel involved in surgery. In addition to accommodating this extra source of intraoperative information all other necessary sources of data relevant to the procedure must be presented...
2015: British Journal of Neurosurgery
Krešimir Rotim, Tomislav Sajko, Marta Borić, Ante Subašić
Surgical treatment of lumbar intervertebral disc herniation is one of the most common neurosurgical procedures. Besides conventional surgical techniques, in the last more than 30 years, different methods with minimal damage to neuromuscular spine structures are being developed and introduced, all having the purpose of reducing postoperative back pain. The advantages of the minimally invasive spine surgery include: possibility of performing procedures under local anaesthesia, reduced hospital stay, limited blood loss with consecutively reduced fibrous tissue development...
March 2015: Lijec̆nic̆ki Vjesnik
Priska Bastola, Hemant Bhagat, Jyotsna Wig
BACKGROUND AND AIMS: Both inhalational and intravenous anaesthetic agents are being used for neuroanaesthesia. Clinical trials comparing "propofol and sevoflurane" and "desflurane and sevoflurane" have been published. However, the comparison of all the three anaesthetics in neurosurgical patients has not been done. A randomised clinical study was carried out comparing propofol, sevoflurane and desflurane to find the ideal neuroanaesthetic agent. METHODS: A total of 75 adult patients undergoing elective craniotomy for supratentorial tumours were included in the study...
May 2015: Indian Journal of Anaesthesia
E Vázquez-Alonso, N Fábregas, P Rama-Maceiras, I Ingelmo Ingelmo, R Valero Castell, L Valencia Sola, F Iturri Clavero
OBJECTIVES: To determine the protocols used by Spanish anaesthesiologists for thromboprophylaxis and anticoagulant or antiplatelet drugs management in neurosurgical or neurocritical care patients. MATERIAL AND METHODS: An online survey with 22 questions, with one or multiple options, launched by the Neuroscience Subcommittee of the Spanish Anaesthesia Society and available between June and October 2012. RESULTS: Of the 73 hospitals included in the National Hospitals Catalogue, a valid response to the online questionnaire was received by 41 anaesthesiologists from 37 sites (response rate 50...
December 2015: Revista Española de Anestesiología y Reanimación
Imelda M Galvin, Ron Levy, J Gordon Boyd, Andrew G Day, Micheal C Wallace
BACKGROUND: Patients undergoing neurosurgery are at risk of cerebral ischaemia with resultant cerebral hypoxia and neuronal cell death. This can increase both the risk of mortality and long term neurological disability. Induced hypothermia has been shown to reduce the risk of cerebral ischaemic damage in both animal studies and in humans who have been resuscitated following cardiac arrest. This had lead to an increasing interest in its neuroprotective potential in neurosurgical patients...
2015: Cochrane Database of Systematic Reviews
A V Rylova, A G Gavrilov, A Iu Lubnin, A A Potapov
Despite difficulties in providing xenon anaesthesia, xenon still seems to be attractive for neurosurgical procedures. But data upon its effect on intracranial (ICP) and cerebral perfusion pressure (CPP) remains controversial. We monitored ICP and CPP in patients with or without intracranial hypertension during xenon inhalation in different concentrations. Our results suggest that caution should be used while inhaling xenon in high anaesthetic concentration in patients wiith known intracranial hypertension. We also address new possibilities of xenon use, e...
July 2014: Anesteziologiia i Reanimatologiia
Nils H Münter, Ana Stevanovic, Rolf Rossaint, Christian Stoppe, Robert D Sanders, Mark Coburn
BACKGROUND: Randomised controlled trials (RCTs) are the gold standard for measuring the efficacy of any medical intervention. The present study assesses the implementation of the CONSORT statement in the top 11 anaesthesiology journals in 2011. OBJECTIVES: We designed this study in order to determine how well authors in the top 11 ranked anaesthesiology journals follow the CONSORT statement's criteria. DESIGN: A retrospective cross-sectional data analysis...
February 2015: European Journal of Anaesthesiology
Remadevi R, D Dinesh Babu, K Sureshkumar, Shubhada A Patil
Anaesthesia for patient with pituitary adenoma posted for non-neurosurgical surgeries is a challenge to the anaesthesiologist with the risk of sudden change in intracranial dynamics during administration of spinal anaesthesia or during stress response of general anaesthesia. There is a chance of increase in tumour size during antenatal period. A careful assessment of pituitary function and a screening of visual field and fundus examination are essential to rule out any mass effect. We are presenting the anaesthetic management of patient with pituitary macroadenoma posted for elective caesarean section done under epidural anaesthesia due to its rarity...
July 2014: Journal of Clinical and Diagnostic Research: JCDR
Sundeep T Pawar, Soumya S Nath, Farrukh Ansari
We report a case of hyperglycaemia and ketosis developing in a non-diabetic patient who underwent a neurosurgical procedure under general anaesthesia. A 52-year-old non-diabetic female patient underwent excision of acoustic neuroma under general anaesthesia. Pancreatic function was not disturbed and she received a single dose of dexamethasone (8 mg) and paracetamol (1 g). Delayed recovery from anaesthesia occurred. On investigation, she was found to have hyperglycaemia and ketosis. She was further managed on the line of diabetic ketoacidosis...
July 2014: Anaesthesiology Intensive Therapy
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