Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Oct 2023
Postoperative Learning and Memory Dysfunction Is More Severe in Males But Is Not Persistent and Transmittable to Next Generation in Young Adult Rats.
Postoperative cognitive dysfunction (POCD) affects numerous patients each year and is associated with poor outcomes. Currently, the duration of POCD is not known. This preclinical study determined whether POCD was persistent, different between sexes and transmittable to the next generation. ⋯ Our results suggest that both male and female rats develop POCD but that the learning and memory dysfunction appears to be more severe in male rats. POCD may not be persistent and does not transmit to the next generation.
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J Neurosurg Anesthesiol · Oct 2023
Randomized Controlled TrialInfluence of Minimum Alveolar Concentration and Inhalation Duration of Sevoflurane on Facial Nerve Electromyography in Hemifacial Spasm: A Randomized Controlled Trial.
The lateral spread response (LSR) is an electromyography feature of hemifacial spasm; intraoperative reduction in the LSR is associated with positive surgical outcomes. This study examined the effects of different minimum alveolar concentrations (MACs) and durations of sevoflurane inhalation on the LSR. ⋯ The combination of intravenous propofol-remifentanil anesthesia with 0.5 MAC sevoflurane allows reliable intraoperative LSR monitoring in hemifacial spasm patients. Our findings support the central rather than peripheral hypothesis of the LSR.
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J Neurosurg Anesthesiol · Oct 2023
Meta AnalysisScalp Nerve Block, Local Anesthetic Infiltration, and Postoperative Pain After Craniotomy: A Systematic Review and Network Meta-analysis of Randomized Trials.
The most efficacious methods for controlling postoperative pain in craniotomy remain unknown. A systematic review and network meta-analysis were performed to compare the efficacies of different strategies of scalp nerve block (SNB), scalp infiltration (SI), and control in patients undergoing craniotomy. MEDLINE, Embase, and CENTRAL databases were searched for randomized controlled trials. ⋯ SNB using bupivacaine, lidocaine, and epinephrine combined, and SNB using ropivacaine, were likely the most efficacious methods for opioid consumption reduction (SUCRA, 88% and 80%, respectively). In summary, different methods of SNB / SI seem to have different efficacies after craniotomy. SNB using ropivacaine may be superior to other methods for postcraniotomy pain control; however, the overall quality of evidence was low.