Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2010
Historical Article"Scalp block" during craniotomy: a classic technique revisited.
Local anesthesia of the nerves of the scalp is referred to as "scalp block." This technique was originally introduced more than a century ago, but has undergone a modern rebirth in intraoperative and postoperative anesthetic management. Here, we review the use of "scalp block" during craniotomy with its anatomic basis, historical evolution, current technique, potential advantages, and pitfalls. We also address its current and potential future applications.
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J Neurosurg Anesthesiol · Jul 2010
Cerebral pial vascular changes under propofol or sevoflurane anesthesia during global cerebral ischemia and reperfusion in rabbits.
Propofol and sevoflurane are commonly used anesthetics for neurosurgery. The aim of the study was to compare the effects of propofol with sevoflurane on cerebral pial arteriolar and venular diameters during global brain ischemia and reperfusion. ⋯ Propofol and sevoflurane acted differently on pial vessels during reperfusion after ischemic insult. Pial arterioles and venules did not dilate immediately after reperfusion, and subsequently constricted throughout the reperfusion period in propofol-anesthetized rabbits. In contrast, pial arterioles and venules dilated temporarily and returned to baseline in sevoflurane-anesthetized rabbits.
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J Neurosurg Anesthesiol · Jul 2010
Accreditation and standardization of neuroanesthesia fellowship programs: results of a specialty-wide survey.
The question of accreditation and standardization of neuroanesthesia fellowship training programs in the U. S. has been discussed extensively within the field. Although numerous opinion pieces have been published, there are no data indicating the level of support or opposition for accreditation of subspecialty training among specialists in the field of neuroanesthesia. ⋯ Career development, neurocritical care, and intraoperative neuromonitoring were the top 3 subjects thought to be essential to a neuroanesthesia fellowship. The majority supported a 1-year fellowship training program. These data indicate measurable support among members of SNACC for a process toward the accreditation of neuroanesthesia fellowship training programs.
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J Neurosurg Anesthesiol · Jul 2010
The effect of sevoflurane on neuronal degeneration and GABAA subunit composition in a developing rat model of organotypic hippocampal slice cultures.
The GABA(A) receptor subunit composition undergoes a switch from a predominantly alpha2 to a predominantly alpha1 around postnatal day (PND) 7 in a rat pup. This developmental switch in the GABA(A) receptor subunit composition changes the kinetics and pharmacologic properties of the GABA(A) receptor. Using a developmental organotypic hippocampal slice model, we hypothesized that the developmental changes in the GABA(A) receptor subunit composition may promote neurodegeneration after exposure to sevoflurane. ⋯ This in vitro investigation supports an age-dependent and GABA(A) receptor subunit composition relationship between 2.0% sevoflurane exposure and cell death.