Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2017
Review Meta AnalysisEffects of Acupuncture in Anesthesia for Craniotomy: A Meta-Analysis.
Acupuncture treatment has been used in China for >2500 years, and at present it is used worldwide as a form of analgesia in patients with acute and chronic pain. Furthermore, acupuncture is regularly used not only as a single anesthetic technique but also as a supplement or in addition to general anesthesia (GA). ⋯ The analysis suggests that the complementary use of acupuncture for craniotomy has additional analgesic effects, reduces the needed amount of volatile anesthetic, reduces the onset of postoperative nausea and vomiting, and might have protective effects on brain tissue. Our findings may stimulate future randomized controlled trials to provide definitive recommendations.
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J Neurosurg Anesthesiol · Jul 2017
Perianesthetic Management of Patients With Thyroid-Stimulating Hormone-Secreting Pituitary Adenomas.
Thyroid-stimulating hormone (TSH)-secreting pituitary adenomas are a rare cause of secondary hyperthyroidism. Anesthetic management of these patients has not been formally described in the literature. ⋯ Patients having resection of TSH-secreting pituitary adenomas can present in any thyroid state. An awareness of risks and potential complications in patients with TSH-secreting adenomas can help tailor perioperative care.
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J Neurosurg Anesthesiol · Jul 2017
Observational StudyCerebral Oxygenation Under General Anesthesia Can Be Safely Preserved in Patients in Prone Position: A Prospective Observational Study.
The effects of prone position (PP) on cerebral tissue metabolism are not well known. The aim of this investigation was to evaluate regional cerebral oxygen desaturation in patients undergoing lumbar spine surgery in PP during routine anesthesia management. ⋯ The results of our study show that margin of safety against impaired cerebral oxygenation can be maintained in PP. Preventing bradycardia and arterial hypotension is crucial. Older patients and those at higher perioperative risk need more meticulous attention.
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J Neurosurg Anesthesiol · Jul 2017
Noninvasive Hemodynamic Measurements During Neurosurgical Procedures in Sitting Position.
Neurosurgical procedures in sitting position need advanced cardiovascular monitoring. Transesophageal echocardiography (TEE) to measure cardiac output (CO)/cardiac index (CI) and stroke volume (SV), and invasive arterial blood pressure measurements for systolic (ABPsys), diastolic (ABPdiast) and mean arterial pressure (MAP) are established monitoring technologies for these kind of procedures. A noninvasive device for continuous monitoring of blood pressure and CO based on a modified Penaz technique (volume-clamp method) was introduced recently. In the present study the noninvasive blood pressure measurements were compared with invasive arterial blood pressure monitoring, and the noninvasive CO monitoring to TEE measurements. ⋯ The noninvasive device based on a modified Penaz technique cannot replace arterial blood pressure monitoring or TEE in anesthetized patients undergoing neurosurgery in sitting position.
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J Neurosurg Anesthesiol · Jul 2017
Effects of Prone Position and Positive End-Expiratory Pressure on Noninvasive Estimators of ICP: A Pilot Study.
Prone positioning and positive end-expiratory pressure can improve pulmonary gas exchange and respiratory mechanics. However, they may be associated with the development of intracranial hypertension. Intracranial pressure (ICP) can be noninvasively estimated from the sonographic measurement of the optic nerve sheath diameter (ONSD) and from the transcranial Doppler analysis of the pulsatility (ICPPI) and the diastolic component (ICPFVd) of the velocity waveform. ⋯ Noninvasive ICP estimation may be useful in patients at risk of developing intracranial hypertension who require prone positioning.