Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2014
Randomized Controlled Trial Comparative StudyA Comparison of the GlideScope With the Macintosh Laryngoscope for Nasotracheal Intubation in Patients With Ankylosing Spondylitis.
The GlideScope (GS) video laryngoscope has been proven to be a suitable intubating device for a predicted difficult intubation. Patients with ankylosing spondylitis (AS) presented with particularly challenging airway management problems to the anesthesiologists. The benefits of using a GS in these patients have not been fully explored. The aim of this study was to evaluate the effectiveness of the GS, in comparison with the Macintosh laryngoscope, when performing nasotracheal intubation in patients with AS under general anesthesia. ⋯ The GS reduced the difficulty of tracheal intubation and provided a better laryngoscopic view with higher overall success rates and shorter duration of intubation attempts than the Macintosh laryngoscope. In our study, the GS proved to be a better alternative in most cases, compared with the Macintosh laryngoscope, for intubating AS patients who preferred their airway management under general anesthesia.
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J Neurosurg Anesthesiol · Jan 2014
Randomized Controlled Trial Comparative StudyThe Effects of Neuromuscular Blockade on Operating Conditions During General Anesthesia for Spinal Surgery.
Muscle relaxants are prescribed routinely for patients undergoing general anesthesia, but the requirement for paralysis in spinal surgery is unclear. This study compared the operating conditions of general anesthesia with and without a muscle relaxant on spinal surgery patients. ⋯ General anesthesia without muscle relaxant provides similar working conditions to those observed with muscle relaxant, and it is associated with earlier eye opening and extubation and higher level of consciousness on emergence from spinal surgery.
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J Neurosurg Anesthesiol · Jan 2014
Randomized Controlled Trial Comparative StudyRecovery from Anesthesia after Craniotomy for Supratentorial Tumors: Comparison of Propofol-Remifentanil and Sevoflurane-Sufentanil (the PROMIFLUNIL Trial).
Rapid recovery after supratentorial tumors (STT) removal is important. Short-acting anesthetics, such as propofol and remifentanil might favor this objective. The aim of this study was to compare the recovery of 2 Bispectral index (BIS)-guided anesthesia protocols combining sevoflurane-sufentanil (SS) or propofol-remifentanil (PR) administered during craniotomy for STT. ⋯ During craniotomy for STT, we could not demonstrate a reduction in the time to extubation when comparing a BIS-guided anesthesia associating PR to a BIS-guided anesthesia associating SS (Clinicatrials.gov identifier: NCT00389883).
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J Neurosurg Anesthesiol · Jan 2014
A Retrospective Analysis of Stridor After Vestibular Schwannoma Surgery.
Transient lower cranial nerve deficits may occur after surgery in the posterior cranial fossa. Stridor has been reported after cerebellopontine angle epidermoid resection. The aim of this retrospective study is to find out whether any preoperative, intraoperative, and postoperative factors lead to stridor after resection of vestibular schwannoma. ⋯ The identification of the exact etiology of stridor often is difficult. Our results suggest that stridor may be more likely in patients who were difficult to intubate, had longer duration of surgery, who develop facial and neck edema and upperlimb weakness, poor cough, and swallowing after surgery. Establishing airway patency with intubation of the trachea may be required if patients develop oxygen desaturation due to stridor.