Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study
Effects of an alveolar recruitment maneuver on subdural pressure, brain swelling, and mean arterial pressure in patients undergoing supratentorial tumour resection: a randomized crossover study.
Although recruitment maneuvers have been advocated as part of a lung protective ventilation strategy, their effects on cerebral physiology during elective neurosurgery are unknown. Our objectives were to determine the effects of an alveolar recruitment maneuver on subdural pressure (SDP), brain relaxation score (BRS), and cerebral perfusion pressure among patients undergoing supratentorial tumour resection. ⋯ Our results suggest that recruitment maneuvers increase subdural pressure and reduce cerebral perfusion pressure, although the clinical importance of these findings is thus far unknown. This trial was registered with ClinicalTrials.gov, NCT02093117.
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Our department monitors the quality of anesthesiologists' clinical supervision and provides each anesthesiologist with periodic feedback. We hypothesized that greater differentiation among anesthesiologists' supervision scores could be obtained by adjusting for leniency of the rating resident. ⋯ Use of logistic regression with leniency results in greater detection of anesthesiologists with significantly better (or worse) clinical supervision scores than use of Student's t tests (i.e., without adjustment for rater leniency).