Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2017
Comparative StudyThe Effect of Position on PaCO2 and PETCO2 in Patients Undergoing Cervical Spine Surgery in Supine and Prone Position.
As per American Society of Anesthesiologists guidelines, continuous monitoring of end tidal carbon dioxide (PETCO2) is recommended as standard II basics of anesthetic monitoring especially to ensure adequate ventilation during all anesthetics. Continuous monitoring of PETCO2 can also be used as a guide to maintain the partial pressure of carbon dioxide in arterial blood (PaCO2) to desired level during the surgery. ⋯ PETCO2 can be used as a reliable guide to estimate PaCO2 during cervical spine procedures in prone position.
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J Neurosurg Anesthesiol · Jul 2017
Intraoperative and Postoperative Administration of Dexmedetomidine Reduces Anesthetic and Postoperative Analgesic Requirements in Patients Undergoing Cervical Spine Surgeries.
Early recovery from anesthesia and avoidance of analgesics with respiratory depressant properties are vital for maintenance of extubated airway in cervical spine surgeries. The current study investigated the role of dexmedetomidine as an anesthetic sparing agent and as a sole postoperative analgesic in these cases. ⋯ Dexmedetomidine lowered the anesthetic requirement with clinically permissible hemodynamic variations without undue prolongation of recovery time. Postoperative dexmedetomidine infusion provided effective analgesia without excessive sedation in patients undergoing cervical spine surgeries.
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J Neurosurg Anesthesiol · Jul 2017
Observational StudyEvaluation of the Effect of Aneurysmal Clipping on Electrocardiography and Echocardiographic Changes in Patients With Subarachnoid Hemorrhage: A Prospective Observational Study.
Electrocardiographic (ECG) and echocardiographic changes that are subsequent to aneurysmal subarachnoid hemorrhage (a-SAH) are commonly observed with a prevalence varying from 27% to 100% and 13% to 18%, respectively. There are sparse data in the literature about the pattern of ECG and echocardiographic changes in patients with SAH after clipping of the aneurysm. Hence, we observed the effect of aneurysmal clipping on ECG and echocardiographic changes during the first week after surgery, and the impact of these changes on outcome at the end of 1 year. ⋯ The ECG changes, such as QTc prolongation, bradycardia, conduction abnormality, and echocardiographic changes, recover on postoperative day-1, in most of the cases after clipping. Patients with combined ECG and echocardiographic changes tend to have poor neurological outcome at the end of 1 year.
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J Neurosurg Anesthesiol · Jul 2017
Laryngeal Mask Ventilation During Lumbar Spine Neurosurgery in Knee-Chest Position is Feasible.
This study describes our experience with laryngeal mask (LM) inserted after anesthetic induction in patients already in knee-chest position for lumbar neurosurgery. ⋯ LM airway management during lumbar neurosurgery in knee-chest position is feasible for selected patients when the anesthetist is experienced.