Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2012
Randomized Controlled TrialCerebral effect of acute normovolemic hemodilution during brain tumor resection.
Acute normovolemic hemodilution (ANH) is used in major surgery expected to be accompanied by excessive blood loss. Reducing the hemoglobin content may disturb cerebral oxygen balance. The aim of this study was to assess the effect of ANH on cerebral oxygen balance in patients subjected to brain tumor resection. ⋯ ANH and allogenic blood transfusion used in this study design were accompanied by comparable cerebral oxygenation parameters in patients subjected to brain tumor resection.
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J Neurosurg Anesthesiol · Jan 2012
Long-term intrathecal drug administration for chronic nonmalignant pain.
Chronic pain of nonmalignant origin requires effective long-term treatments, as for many patients pain management will be necessary throughout the rest of their lives. Intrathecal drug delivery systems (IDDS) have become a recognized therapy for the management of severe and otherwise intractable chronic pain. However, it is still not clear whether this treatment can be effective for periods up to 10 years or longer, given the paucity of long-term follow-up. This study sought to examine the effectiveness of IDDS following an average of 13 years postimplantation. ⋯ This study, with one of the longest follow-up intervals reported in the IDDS literature, shows that IDDS has the potential to be a life-long pain management solution in appropriately selected patients with chronic nonmalignant pain.
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J Neurosurg Anesthesiol · Jan 2012
The neuroprotective effect of agmatine after focal cerebral ischemia in diabetic rats.
Diabetes mellitus is a metabolic disorder associated with structural and functional alterations of various organ systems including the central nervous system. The aim of present study was to investigate the neuroprotective effect of agmatine (AGM) on cerebral ischemic damage in diabetic rats. ⋯ AGM posttreatment reduced cerebral infarct size and neurological deficit expression in diabetic rats subjected to MCAO. The reduced infarct size was associated with a decrease in apoptosis and NOS expression.
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The electroencephalogram contains small electrical signals that are vulnerable to contamination from high-frequency noise during electrocautery. The bispectral index (BIS) monitor incorporated hardware and software changes to eliminate artifacts, thus allowing BIS monitoring even in the presence of electrocautery. We evaluated the accuracy of BIS to measure anesthetic effect during electrocautery interference. ⋯ Rejecting and filtering artifacts from electrocautery interference reduced the ability of BIS to respond to a change in anesthetic depth. BIS values during electrocautery should be interpreted with caution.