Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2011
Randomized Controlled Trial Comparative StudyComparison of A-line autoregressive index and observer assessment of alertness/sedation scale for monitored anesthesia care with target-controlled infusion of propofol in patients undergoing percutaneous vertebroplasty.
Percutaneous vertebroplasty (PV) with monitored anesthesia care (MAC) is a growing trend. Without adequate sedation, patient movement can affect and even interrupt the procedure during MAC. The aim of this study was to compare the performance of the auditory-evoked potential (AEP) index and the Observer Assessment of Alertness/Sedation (OAA/S) scale as indicators of depth of sedation in patients undergoing PV. ⋯ TCI propofol with AEP monitoring can provide less patient movement, better sedation, and higher surgeon satisfaction in patients during prone-position PV procedures than can TCI propofol with OAA/S monitoring.
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J Neurosurg Anesthesiol · Jan 2011
Development of a safe and pragmatic awake craniotomy program at Maine Medical Center.
Awake craniotomy offers an excellent means of performing intraoperative mapping and optimizing surgical resection of brain tumors. Awake craniotomy relies on a strong collaboration between anesthesiologists, neurosurgeons, and operating room staff. The authors recently introduced awake craniotomy for tumor resection at the Maine Medical Center and propose that it can be performed safely, effectively, and efficiently in a high-volume community hospital. ⋯ With attention focused on patient selection and a streamlined anesthetic protocol, the authors were able to successfully implement an awake craniotomy protocol in a community setting with satisfying results, including low operative morbidity, short operative times, low anesthetic complications, and excellent patient tolerance.
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J Neurosurg Anesthesiol · Jan 2011
Serial measurement of static and dynamic cerebrovascular autoregulation after brain injury.
In patients with neuronal injury, the knowledge of the status of cerebrovascular autoregulation can help to optimize the management of the cerebral perfusion pressure. This study characterizes dynamic and static cerebrovascular autoregulation during the first 7 days after severe traumatic brain injury or intracranial hemorrhage. ⋯ Daily measured dAR and sAR were impaired after brain injury with a nadir on day 4 and consecutive incomplete recovery over time.