Journal of neurosurgical anesthesiology
-
J Neurosurg Anesthesiol · Apr 2009
Letter Case ReportsTakotsubo syndrome after carotid endarterectomy.
-
J Neurosurg Anesthesiol · Apr 2009
Randomized Controlled Trial Comparative StudyAwake craniotomy induces fewer changes in the plasma amino acid profile than craniotomy under general anesthesia.
In this prospective, observational, 2-armed study, we compared the plasma amino acid profiles of patients undergoing awake craniotomy to those undergoing craniotomy under general anesthesia. Both experimental groups were also compared with a healthy, age-matched and sex-matched reference group not undergoing surgery. It is our intention to investigate whether plasma amino acid levels provide information about physical and emotional stress, as well as pain during awake craniotomy versus craniotomy under general anesthesia. ⋯ Between experimental groups, a significant increase in large neutral amino acids was found postoperatively in awake craniotomy patients, pain was also less and recovery was faster. A significant difference in mean hospitalization time was also found, with awake craniotomy patients leaving after 4.53+/-2.12 days and general anesthesia patients after 6.17+/-1.62 days; P=0.012. This study demonstrates that awake craniotomy is likely to be physically and emotionally less stressful than general anesthesia and that amino acid profiling holds promise for monitoring postoperative pain and recovery.
-
J Neurosurg Anesthesiol · Apr 2009
Randomized Controlled TrialEEG entropy values during isoflurane, sevoflurane and halothane anesthesia with and without nitrous oxide.
We hypothesized that like bispectral index, entropy may be anesthetic agent specific. We carried out a study to assess the entropy values of different anesthetics at equi-minimal alveolar concentrations (MACs) with air and nitrous oxide as carrier gases. Thirty adult patients undergoing spine surgery were randomized to receive halothane, isoflurane, or sevoflurane, in 2 stages, (a) with air/oxygen mixture (2:1) and (b) in nitrous oxide/oxygen (2:1). ⋯ At 1.5 MAC for all agents, after addition of nitrous oxide, there was an insignificant reduction in both RE and SE (P>0.05). Again the values of RE and SE remained high for halothane as compared with isoflurane and sevoflurane. In conclusion, our data suggest a possibility of misinterpretation of anesthetic hypnosis when entropy values increase with addition of nitrous oxide to 1 MAC isoflurane and sevoflurane.