Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2025
Epidemiology of Post-craniotomy Hypertension and Its Association With Adverse Outcome(s): A Systematic Review and Meta-analysis.
After intracranial surgery, sympathetic overdrive and increased blood catecholamine levels can contribute to postoperative hypertension, a significant clinical problem. The objective of this review was to summarize, quantify, and assess the epidemiological perspective of post-craniotomy hypertension and its association with adverse outcomes. This PROSPERO-registered systematic review was conducted following PRISMA guidelines. ⋯ There were insufficient data to investigate the quantitative association of post-craniotomy hypertension with 30-day adverse events. In summary, 1 out of 3 patients exhibited hypertension post-craniotomy, and this was associated with a significantly higher risk of having intracranial hemorrhage within 72 hours post-procedure. A generally accepted and clinically relevant criteria for post-craniotomy hypertension should be defined.
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J Neurosurg Anesthesiol · Jan 2025
Effects of Scalp Nerve Block on Symptomatic Cerebral Hyperperfusion Syndrome After Combined Revascularization Surgery for Moyamoya Disease.
Strict blood pressure control can be used to prevent or treat cerebral hyperperfusion syndrome. This study investigated whether scalp nerve block (SNB) is associated with a reduced risk of postoperative symptomatic cerebral hyperperfusion syndrome (SCHS) by reducing postoperative blood pressure in adult patients who underwent combined revascularization surgery for moyamoya disease. ⋯ Despite some potential benefits, SNB was not associated with a reduced incidence of postoperative SCHS in adult patients who underwent combined revascularization surgery for moyamoya disease.
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J Neurosurg Anesthesiol · Jan 2025
Comparison of Intubating Conditions Between Direct Laryngoscopy and C-MAC Video-laryngoscopy in Patients With Simulated Cervical Spine Immobilization: A Systematic Review and Meta-analysis.
Intubation of patients requiring cervical spine immobilization can be challenging. Recently, the use of C-MAC video laryngoscopes (VL) has increased in popularity over direct laryngoscopy (DL). We aimed to conduct a systematic review and meta-analysis to evaluate the efficacy of C-MAC VL as compared with DL for intubation in C-spine immobilized patients. ⋯ There was no difference in terms of the difficulty of intubation and the use of optimization maneuvers. Overall, C-MAC VL did not reduce the time taken to intubate, although the strength of this finding is limited by wide confidence intervals. C-MAC VL significantly improved laryngoscopy views and first-pass success rate as compared with DL.
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J Neurosurg Anesthesiol · Jan 2025
The Role of Processed Electroencephalography in the Detection and Management of Acute Cerebral Ischemia: A Scoping Review.
Processed electroencephalography (pEEG) is increasingly used to titrate the depth of anesthesia. Whether such intra-procedural pEEG monitoring can offer additional information on cerebral perfusion or acute focal or global cerebral ischemia is unknown. This scoping review aimed to provide a narrative analysis of the current literature reporting the potential role of pEEG in adults with acute cerebral ischemia. ⋯ Low sensitivity associations between pEEG indices and cerebral blood flow were highlighted, which may be influenced by cerebral autoregulatory thresholds. Despite the associations reported in observational studies, this review identified significant uncertainty in the role of pEEG during cerebral ischemia. There is a paucity of high-level observational (cohort or case-control) or randomized trial research examining the possible role of pEEG for the detection and management of cerebral ischemia during acute stroke, including during endovascular therapy, or in other common scenarios of acute cerebral ischemia.
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J Neurosurg Anesthesiol · Jan 2025
Learnings From an Audit of Anesthesia Information Management System for Neurosurgery Operating Room Utilization.
An anesthesia information management system (AIMS) can be used to assess operating room utilization. The aim of this study was to assess neurosurgery OR utilization patterns using an AIMS. ⋯ AIMS can effectively track and identify operating room utilization patterns by analyzing the durations of various operating room activities. Prospective multicenter studies are required to validate these findings in different surgical populations and centers.