Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2013
Randomized Controlled TrialBIS-guided anesthesia decreases postoperative delirium and cognitive decline.
BIS use in elderly patients targeting a BIS of 40-60 may reduce post-operative delirium and post-operative cognitive decline at 3 months.
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J Neurosurg Anesthesiol · Jan 2013
Randomized Controlled TrialThe effect of furosemide on intravascular volume status and electrolytes in patients receiving mannitol: an intraoperative safety analysis.
Mannitol is often used during intracranial surgery to improve surgical exposure. Furosemide is often added to mannitol to augment this effect. The concern exists, however, that the augmented diuresis caused by the addition of furosemide to mannitol may cause hypovolemia and hypoperfusion, hypokalemia, and hyponatremia. We examined the intraoperative safety of low-dose furosemide (0.3 mg/kg) combined with mannitol (1 g/kg). ⋯ Despite an increase in urine output by as much as 67%, adding low-dose furosemide to mannitol does not seem to produce significant electrolyte derangements or hypovolemia compared with the administration of mannitol alone.
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J Neurosurg Anesthesiol · Jan 2013
Aerosolized lidocaine during invasive mechanical ventilation: in vitro characterization and clinical efficiency to prevent systemic and cerebral hemodynamic changes induced by endotracheal suctioning in head-injured patients.
In patients with severe brain injury, endotracheal suctioning (ETS) can increase intracranial pressure (ICP) and reduce cerebral perfusion pressure (CPP). The aim of this prospective, blinded clinical trial was to assess the effectiveness of aerosolized lidocaine to prevent increase of ICP induced by ETS in mechanically ventilated head-injured patients. ⋯ Aerosolized lidocaine (2 mg/kg) can prevent ETS-induced increases in ICP, without modifying systemic and cerebral hemodynamics in deeply sedated patients.