Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2015
Randomized Controlled Trial Comparative StudySedation for Electroencephalography With Dexmedetomidine or Chloral Hydrate: A Comparative Study on the Qualitative and Quantitative Electroencephalogram Pattern.
Sedation for electroencephalography in uncooperative patients is a controversial issue because majority of sedatives, hypnotics, and general anesthetics interfere with the brain's electrical activity. Chloral hydrate (CH) is typically used for this sedation, and dexmedetomidine (DEX) was recently tested because preliminary data suggest that this drug does not affect the electroencephalogram (EEG). The aim of the present study was to compare the EEG pattern during DEX or CH sedation to test the hypothesis that both drugs exert similar effects on the EEG. ⋯ The differences of DEX and CH in EEG power did not change the EEG qualitative interpretation, which was similar with the 2 drugs. Other studies comparing natural sleep and sleep induced by these drugs are needed to clarify the clinical relevance of the observed EEG quantitative differences.
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J Neurosurg Anesthesiol · Jan 2015
Randomized Controlled Trial Comparative StudyComparison of the I-gel Laryngeal Mask Airway With the LMA-Supreme for Airway Management in Patients Undergoing Elective Lumbar Vertebral Surgery.
The single-use supreme-laryngeal mask airway (LMA) [corrected] has been reported to be suitable for airway management in the prone position. However, there are a limited number of cases using the I-gel in the prone position. In this study, we compared the clinical use of the 2 devices in adult patients undergoing elective lumbar vertebral surgery in the prone position. ⋯ The I-gel laryngeal mask airway can also be used safely in airway management of patients undergoing lumbar surgery in the prone position as well as the LMA [corrected].
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J Neurosurg Anesthesiol · Jan 2015
Prolonged Mechanical Ventilation is Associated With Pulmonary Complications, Increased Length of Stay, and Unfavorable Discharge Destination Among Patients With Subdural Hematoma.
Although subdural hematoma (SDH) is common in neurocritical practice, little is known about SDH patients requiring prolonged mechanical ventilation (PMV). We aimed to determine predictors of PMV and its relationship with outcome in patients with SDH. ⋯ PMV is associated with pulmonary complications, increased LOS, and unfavorable discharge destination in patients with SDH. Alcohol abuse, admission GCS, and surgical evacuation are associated with PMV among patients with SDH. Future studies should investigate the role of early tracheostomy in high-risk patients and impact on outcomes.