Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Apr 2012
Randomized Controlled Trial Comparative StudyComparison between intraoperative fentanyl and tramadol to improve quality of emergence.
Cough causes poor quality of emergence from anesthesia and risks of several complications. We compared fentanyl and an antitussive action of tramadol on the quality of emergence and postoperative outcome. ⋯ A dose of 1 mg/kg of tramadol administered intravenously 30 minutes before the expected extubation, compared with 1 μg/kg of fentanyl, decreased cough incidence, improved emergence quality, and provided stable hemodynamics. However, there was no significant difference between tramadol and fentanyl in pain scores and fentanyl consumption postoperatively.
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J Neurosurg Anesthesiol · Apr 2012
Randomized Controlled Trial Comparative StudyComparison of the effects of etomidate and propofol combined with remifentanil and guided by comparable BIS on transcranial electrical motor-evoked potentials during spinal surgery.
Transcranial electrical motor-evoked potentials (TceMEPs) can provide early warning of possible motor compromise during surgery. There are fewer reports comparing the effects of etomidate and propofol infusion on TceMEPs when used for the maintenance of anesthesia and guided by comparable values of bispectral index (BIS) during spinal surgery. ⋯ Etomidate has more favorable effects than propofol during the monitoring of TceMEPs under comparable BIS levels.
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J Neurosurg Anesthesiol · Apr 2012
Randomized Controlled Trial Comparative StudyThiopental-induced burst suppression measured by the bispectral index is extended during propofol administration compared with sevoflurane.
Thiopental is used to suppress cerebral metabolism during temporary clip ligation of the cerebral arteries. Electroencephalogram (EEG) can measure intraoperative burst suppression as evidence of cerebral metabolic suppression, but EEG is not always available during clip ligation. This study was conducted to compare the effect of propofol-based total intravenous anesthesia (TIVA) with sevoflurane-based inhalational anesthesia on thiopental-induced burst suppression during aneurysm surgery. The effect of thiopental was measured by burst suppression ratio (BSR) using the bispectral index (BIS) monitor. ⋯ Our results suggest that at equivalent BIS values TIVA with propofol anesthesia provides longer duration and greater cerebral metabolic suppression compared with sevoflurane-N(2)O inhalation anesthesia. BIS may be an acceptable alternative to standard EEG monitoring when assessing burst suppression during temporary clipping.
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J Neurosurg Anesthesiol · Apr 2012
Randomized Controlled TrialChanges in intraocular pressure during prone spine surgery under propofol and sevoflurane anesthesia.
Intraocular pressure (IOP) has been shown to increase during prone spine surgery. Although propofol and sevoflurane have been widely used during such surgery, there have been no data to compare the IOP changes under propofol and sevoflurane anesthesia. The present study was therefore conducted to investigate IOP changes under propofol and sevoflurane anesthesia during prone spine surgery. ⋯ The results indicated that the choice of anesthetic agent, sevoflurane or propofol, did not have significant effects on IOP changes during a relatively short interval of prone spine surgery.