Journal of neurosurgical anesthesiology
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On April 16 and 17, 2016, the Fifth biennial Pediatric Anesthesia & Neurodevelopment Assessment (PANDA) symposium was convened at the Morgan Stanley Children's Hospital of New York at Columbia University Medical Center. During the symposium, experts in the fields of anesthesiology, neuropsychology, and epidemiology were convened in a small group session to determine the level of confidence in the current clinical evidence and the next steps in anesthetic neurotoxicity clinical research. ⋯ It was, however, recognized that the continuum of data that is seen in studies of other toxic environmental exposures, such as lead poisoning, has not been established in the anesthetic neurotoxicity literature, specifically regarding the timing of the exposure, the dose effects, contributing perioperative conditions, or vulnerable populations. As a result, these questions may need to be addressed in observational studies to guide future clinical trials.
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J Neurosurg Anesthesiol · Oct 2016
The Effect of Clevidipine on Cerebral Blood Flow Velocity and Carbon Dioxide Reactivity in Human Volunteers.
Clevidipine is a short acting, esterase metabolized, calcium channel antagonist administered as a continuous infusion for control of hypertension. Its profile allows for rapid titration and may be uniquely suited to achieving tight hemodynamic targets in neurosurgical and neurocritical care patients. The present study was designed to investigate the effect of clevidipine infusion on cerebral blood flow and cerebral CO2 responsiveness as measured by cerebral blood flow velocity (CBFV) using transcranial Doppler. ⋯ Clevidipine infusion did not significantly increase CBFV nor was cerebral CO2 reactivity reduced during maximal-dose clevidipine infusion. Further systematic investigation of clevidipine in patients with central nervous system pathology seems justified.
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J Neurosurg Anesthesiol · Oct 2016
Comment Case ReportsBrainstem Contusion: A Fallacy of GCS-BIS Synchrony.