Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2011
ReviewPRO: the "Lund concept" for treatment of patients with severe traumatic brain injury.
Two different main concepts for the treatment of severe traumatic brain injury have been established during the last 15 years, namely the more conventional concept recommended in well-established guidelines (eg, the US Guideline, European Guideline, Addelbrook's Guideline from Cambridge) on the one hand, and the Lund concept from the University Hospital of Lund, Sweden on the other. Owing to the lack of well-controlled randomized outcome studies comparing these 2 main therapeutic approaches, we cannot conclude that one is better than the other. This study is the PRO part in a PRO-CON debate on the Lund concept in the present journal. ⋯ Although conventional guidelines are restricted to clinical data from meta-analytic surveys, the physiological approach of the Lund therapy finds support in both experimental and clinical studies. It offers a wider base and can also give recommendations regarding fluid therapy, lung protection, optimal hemoglobin concentration, temperature control, the use of decompressive craniotomy, and ventricular drainage. This study puts forward arguments in support of the Lund therapy.
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J Neurosurg Anesthesiol · Jul 2011
Randomized Controlled TrialPostoperative analgesic efficacy of intravenous dexketoprofen in lumbar disc surgery.
We investigated the postoperative analgesic efficacy and effect on total tramadol consumption of intravenous dexketoprofen trometamol, a new nonsteroidal anti-inflammatory drug, in patients that had undergone lumbar disc surgery. ⋯ We found that dexketoprofen was an effective analgesic for postdiscectomy pain when used alone or in addition to opioids. It is easy to administer and decreases tramadol consumption and opioid-related side effects.
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J Neurosurg Anesthesiol · Jul 2011
Serious cardiac adverse events after decompressive craniectomy for malignant cerebral infarction.
There is a significant association between cardiac dysfunction and ischemic stroke. The serious cardiac adverse events (SCAEs) after decompressive craniectomy for malignant cerebral infarction from ischemic stroke were studied retrospectively. ⋯ Serious cardiac events are common in the acute period after stroke and decompressive craniectomy, and are important contributors to mortality.
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J Neurosurg Anesthesiol · Jul 2011
Letter Case ReportsPulmonary hypertension in a patient with subarachnoid hemorrhage.