Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2017
Randomized Controlled TrialEquiosmolar Solutions of Hypertonic Saline and Mannitol Do Not Impair Blood Coagulation During Elective Intracranial Surgery.
The authors investigated the effect of equiosmolar, equivolemic solutions of 3% hypertonic saline (HS) and 20% mannitol on blood coagulation assessed by rotational thromboelastometry (ROTEM) and standard coagulation tests during elective craniotomy. ⋯ The use of 5 mL/kg of equiosmolar solutions of 3% HS and 20% mannitol applied to reach a brain relaxation during elective craniotomy does not induce coagulation impairment as evidenced by ROTEM and standard coagulation tests.
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J Neurosurg Anesthesiol · Jan 2017
Comparative StudyComparison of Continuous Noninvasive Blood Pressure Monitoring by TL-300 With Standard Invasive Blood Pressure Measurement in Patients Undergoing Elective Neurosurgery.
Intraoperative blood pressure (BP) is one of the basic vital signs monitoring. Compared with standard invasive BP measurement, TL-300 allows for a continuous and beat-to-beat noninvasive intraoperative BP monitoring. The current retrospective study compared the accuracy and precision of this noninvasive technique for continuous BP monitoring with that of standard invasive BP measurement in patients undergoing elective neurosurgery. ⋯ TL-300 system is a promising noninvasive alternative to the invasive arterial catheter method for intraoperative BP monitoring, with a high accuracy and precision. With the limitation of the current retrospective study, further prospective method comparison studies are needed.
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J Neurosurg Anesthesiol · Jan 2017
Comparative Study Observational StudyComparison of Intra-Abdominal Pressure Among 3 Prone Positional Apparatuses After Changing From the Supine to the Prone Position and Applying Positive End-Expiratory Pressure in Healthy Euvolemic Patients: A Prospective Observational Study.
Positional apparatuses used for the prone position can affect intra-abdominal pressure (IAP). In this study, we compared the IAP after changing to the prone position and applying various positive end-expiratory pressure (PEEP) levels among 3 prone positional apparatuses. ⋯ The IAP in the prone position was significantly lower using the Jackson table compared with the Wilson frame and chest rolls. A PEEP up to 9 cm H2O can be safely used in healthy euvolemic patients undergoing prone spinal surgery without a clinically significant increase in IAP, irrespective of the type of prone positional apparatus.
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J Neurosurg Anesthesiol · Jan 2017
Association Between Perioperative Hyperglycemia and Survival in Patients With Glioblastoma.
Several studies have examined the association between hyperglycemia in the first 10 to 12 weeks following surgery and postoperative survival in glioblastoma multiforme (GBM) patients. We hypothesize that episodes of hyperglycemia before, during and/or following surgery for primary GBM are independent predictors of disease progression and mortality. ⋯ Preoperative hyperglycemia is associated with poor OS after GBM surgery.
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J Neurosurg Anesthesiol · Jan 2017
Intraoperative Monitoring of Diaphragm Neural Pathways During Cervical Surgery by Electrical Stimulation and Recordings of Ventilator Waveforms: Physiological Bases and Pilot Study.
Surgery on the cervical spine entails the risk of damaging the neural structures responsible for diaphragmatic innervation, namely (C3)-C4-(C5) roots. In some "difficult" cases, anatomic identification of these structures may be hard to achieve. Therefore, monitoring of the diaphragm through the ventilation waveforms displayed on the anesthesia machine can be of practical help. According to literature review, very few publications have reported such monitoring. ⋯ Intraoperative monitoring of the diaphragmatic responses to stimulation can be advocated in surgery at the cervical spine level, and also more widely in surgery in the supraclavicular region, when neural structures responsible for diaphragmatic function are at risk.