Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2015
Randomized Controlled Trial Comparative StudyA Comparison of Equivolume, Equiosmolar Solutions of Hypertonic Saline and Mannitol for Brain Relaxation in Patients Undergoing Elective Intracranial Tumor Surgery: A Randomized Clinical Trial.
Hyperosmolar solutions have been used in neurosurgery to modify brain bulk and prevent neurological deterioration. The purpose of the study was to compare the effects of equivolume, equiosmolar solutions of mannitol and hypertonic saline (HTS) on brain relaxation and postoperative complications in patients undergoing elective intracranial tumor surgery. ⋯ Our results suggest that HTS provides better brain relaxation than mannitol during elective intracranial tumor surgery.
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J Neurosurg Anesthesiol · Jan 2015
Randomized Controlled Trial Comparative StudyComparative Study Between Isoflurane, Sevoflurane, and Desflurane in Neurosurgical Pediatric Patients Undergoing Craniotomy for Supratentorial Tumor Resection.
The aim of this prospective, comparative, randomized study was to compare the inhalational anesthetics isoflurane, sevoflurane, and desflurane in pediatric patients undergoing craniotomy for excision of supratentorial tumors. We assessed early postoperative recovery outcome, intraoperative hemodynamics, and degree of brain swelling, as well as postoperative vomiting and shivering. ⋯ Desflurane and sevoflurane can be used to facilitate early emergence from anesthesia in neurosurgical pediatric patients. Emergence times are shorter with desflurane or sevoflurane than with isoflurane. The patients who received desflurane or sevoflurane have similar intraoperative and postoperative incidence of adverse effects compared with those who received isoflurane. Thus, desflurane and sevoflurane can be considered as suitable for emergence in pediatric neurosurgical anesthesia.
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J Neurosurg Anesthesiol · Jan 2015
Clinical Course Score (CCS): A New Clinical Score to Evaluate Efficacy of Neurotrauma Treatment in Traumatic Brain Injury and Subarachnoid Hemorrhage.
Neurotrauma continues to represent a challenging public health issue requiring continual improvement in therapeutic approaches. As no such current system exists, we present in this study the Clinical Course Score (CCS) as a new clinical score to evaluate the efficacy of neurotrauma treatment. ⋯ The CCS can be useful in evaluating different therapeutic approaches during neurotrauma therapy. This new score might improve assessment of beneficial effects of therapeutic procedures.
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J Neurosurg Anesthesiol · Jan 2015
Intravenously Administered Indocyanine Green May Cause Falsely High Near-Infrared Cerebral Oximetry Readings.
Near-infrared spectroscopy assesses cerebral tissue oxygen saturation (Scto2) based on the absorption spectra of oxygenated and deoxygenated hemoglobin. It has been reported that IV-administered dyes including methylene blue, indigo carmine, and indocyanine green (ICG) may cause falsely low-pulse oximetry readings (Spo2). Although methylene blue and indigo carmine may also decrease Scto2, the effect of ICG has not been documented. ⋯ ICG falsely increases the spectroscopy-determined cerebral oxygen saturation for up to 12 minutes but dampens pulse oximetry readings.