Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2025
Comparison of Intubating Conditions Between Direct Laryngoscopy and C-MAC Video-laryngoscopy in Patients With Simulated Cervical Spine Immobilization: A Systematic Review and Meta-analysis.
Intubation of patients requiring cervical spine immobilization can be challenging. Recently, the use of C-MAC video laryngoscopes (VL) has increased in popularity over direct laryngoscopy (DL). We aimed to conduct a systematic review and meta-analysis to evaluate the efficacy of C-MAC VL as compared with DL for intubation in C-spine immobilized patients. ⋯ There was no difference in terms of the difficulty of intubation and the use of optimization maneuvers. Overall, C-MAC VL did not reduce the time taken to intubate, although the strength of this finding is limited by wide confidence intervals. C-MAC VL significantly improved laryngoscopy views and first-pass success rate as compared with DL.
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J Neurosurg Anesthesiol · Jan 2025
The Role of Processed Electroencephalography in the Detection and Management of Acute Cerebral Ischemia: A Scoping Review.
Processed electroencephalography (pEEG) is increasingly used to titrate the depth of anesthesia. Whether such intra-procedural pEEG monitoring can offer additional information on cerebral perfusion or acute focal or global cerebral ischemia is unknown. This scoping review aimed to provide a narrative analysis of the current literature reporting the potential role of pEEG in adults with acute cerebral ischemia. ⋯ Low sensitivity associations between pEEG indices and cerebral blood flow were highlighted, which may be influenced by cerebral autoregulatory thresholds. Despite the associations reported in observational studies, this review identified significant uncertainty in the role of pEEG during cerebral ischemia. There is a paucity of high-level observational (cohort or case-control) or randomized trial research examining the possible role of pEEG for the detection and management of cerebral ischemia during acute stroke, including during endovascular therapy, or in other common scenarios of acute cerebral ischemia.
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J Neurosurg Anesthesiol · Jan 2025
Learnings From an Audit of Anesthesia Information Management System for Neurosurgery Operating Room Utilization.
An anesthesia information management system (AIMS) can be used to assess operating room utilization. The aim of this study was to assess neurosurgery OR utilization patterns using an AIMS. ⋯ AIMS can effectively track and identify operating room utilization patterns by analyzing the durations of various operating room activities. Prospective multicenter studies are required to validate these findings in different surgical populations and centers.
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J Neurosurg Anesthesiol · Jan 2025
Reducing Cerebrospinal Fluid Sampling Frequency and Costs in Patients With Ventriculostomy for Aneurysmal Subarachnoid Hemorrhage: A Quality Improvement Initiative.
We implemented a quality improvement project to transition from routine cerebrospinal fluid (CSF) sampling to indication-based sampling in aneurysmal subarachnoid hemorrhage (aSAH) patients with an external ventricular drain (EVD). ⋯ Transitioning from routine to indication-based CSF sampling in aSAH patients with an EVD reduced sampling frequency and associated costs without increasing infection rates.
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J Neurosurg Anesthesiol · Jan 2025
Radiographic Predictors of Difficult Fiberscopic Intubation During General Anesthesia in Patients With a Cervical Collar to Simulate a Difficult Airway.
Predictors of difficult fiberscopic intubation have not been fully elucidated. This study focused on identifying radiographic predictors of difficult fiberscopic intubation during general anesthesia in patients with a cervical collar. ⋯ High tongue area/oral cavity area and long skin-glottis distance were predictive of difficult fiberscopic intubation during general anesthesia in patients with a cervical collar.