Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2022
Inadvertent Burst Suppression During Total Intravenous Anesthesia in 112 Consecutive Patients Undergoing Spinal Instrumentation Surgery: A Retrospective Observational Quality Improvement Project.
The incidence and quantification of inadvertent electroencephalographic burst suppression during total intravenous anesthesia (TIVA) for spine instrumentation surgery has not previously been reported. ⋯ High rates and prolonged periods of inadvertent burst suppression may be prevalent during spine instrumentation surgery with TIVA. Our findings suggest that usage of electroencephalography alone is incomplete without prompt interpretation and intervention, mandating close communication between neuromonitoring and anesthesia teams. The dose-response relationship between burst suppression, total time spent in maximal burst suppression, and their association with delirium warrants further evaluation.
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J Neurosurg Anesthesiol · Jul 2022
Intensive Care Admission and Management of Patients With Acute Ischemic Stroke: A Cross-sectional Survey of the European Society of Intensive Care Medicine.
No specific recommendations are available regarding the intensive care management of critically ill acute ischemic stroke (AIS) patients, and questions remain regarding optimal ventilatory, hemodynamic, and general intensive care unit (ICU) therapeutic targets in this population. We performed an international survey to investigate ICU admission criteria and management of AIS patients. ⋯ The ICU management of AIS, including therapeutic targets and clinical practice strategies, importantly varies between centers. Our findings may be helpful to define future studies and create a research agenda regarding the ICU therapeutic targets for AIS patients.
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J Neurosurg Anesthesiol · Jul 2022
Postoperative Screening With the Modified National Institutes of Health Stroke Scale After Noncardiac Surgery: A Pilot Study.
Perioperative stroke is associated with high rates of morbidity and mortality, yet there is no validated screening tool. The modified National Institutes of Health Stroke Scale (mNIHSS) is validated for use in nonsurgical strokes but is not well-studied in surgical patients. We evaluated perioperative changes in the mNIHSS score in noncardiac, non-neurological surgery patients, feasibility in the perioperative setting, and the relationship between baseline cognitive screening and change in mNIHSS score. ⋯ Changes in mNIHSS score can occur early after surgery in the absence of overt stroke. Assessment of mNIHSS appears feasible in the perioperative setting, although further research is required to define its role in detecting perioperative stroke.
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J Neurosurg Anesthesiol · Jul 2022
Wellbeing of Frontline Health Care Workers After the First SARS-CoV-2 Pandemic Surge at a Neuroscience Centre: A Cross-sectional Survey.
The coronavirus disease 2019 (COVID-19) pandemic has affected people of all ages, races, and socioeconomic groups, and placed extraordinary stress on health care workers (HCWs). We measured the prevalence of burnout and assessed wellbeing and quality of life (QoL) in HCWs at a single UK neuroscience center after the first pandemic surge. ⋯ Our findings highlight the prevalence of HCW burnout after the first surge of the pandemic, with an increased risk of burnout among nurses and staff from ethnic minority groups. Both nursing and staff from ethnic minority groups were also more fearful for their health. With ongoing pandemic surges, the impact on HCW wellbeing should be continuously assessed to ensure that local strategies to support staff wellbeing are diverse and inclusive.