Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2015
Randomized Controlled Trial Comparative StudyComparative Study Between Isoflurane, Sevoflurane, and Desflurane in Neurosurgical Pediatric Patients Undergoing Craniotomy for Supratentorial Tumor Resection.
The aim of this prospective, comparative, randomized study was to compare the inhalational anesthetics isoflurane, sevoflurane, and desflurane in pediatric patients undergoing craniotomy for excision of supratentorial tumors. We assessed early postoperative recovery outcome, intraoperative hemodynamics, and degree of brain swelling, as well as postoperative vomiting and shivering. ⋯ Desflurane and sevoflurane can be used to facilitate early emergence from anesthesia in neurosurgical pediatric patients. Emergence times are shorter with desflurane or sevoflurane than with isoflurane. The patients who received desflurane or sevoflurane have similar intraoperative and postoperative incidence of adverse effects compared with those who received isoflurane. Thus, desflurane and sevoflurane can be considered as suitable for emergence in pediatric neurosurgical anesthesia.
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J Neurosurg Anesthesiol · Jan 2015
Clinical Course Score (CCS): A New Clinical Score to Evaluate Efficacy of Neurotrauma Treatment in Traumatic Brain Injury and Subarachnoid Hemorrhage.
Neurotrauma continues to represent a challenging public health issue requiring continual improvement in therapeutic approaches. As no such current system exists, we present in this study the Clinical Course Score (CCS) as a new clinical score to evaluate the efficacy of neurotrauma treatment. ⋯ The CCS can be useful in evaluating different therapeutic approaches during neurotrauma therapy. This new score might improve assessment of beneficial effects of therapeutic procedures.
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J Neurosurg Anesthesiol · Jan 2015
Intravenously Administered Indocyanine Green May Cause Falsely High Near-Infrared Cerebral Oximetry Readings.
Near-infrared spectroscopy assesses cerebral tissue oxygen saturation (Scto2) based on the absorption spectra of oxygenated and deoxygenated hemoglobin. It has been reported that IV-administered dyes including methylene blue, indigo carmine, and indocyanine green (ICG) may cause falsely low-pulse oximetry readings (Spo2). Although methylene blue and indigo carmine may also decrease Scto2, the effect of ICG has not been documented. ⋯ ICG falsely increases the spectroscopy-determined cerebral oxygen saturation for up to 12 minutes but dampens pulse oximetry readings.
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J Neurosurg Anesthesiol · Jan 2015
Comparative StudyComparative Study of Trigeminocardiac Reflex After Trigeminal Ganglion Compression During Total Intravenous Anesthesia.
Percutaneous compression of the trigeminal ganglion (PCTG) is an alternative surgical treatment for trigeminal neuralgia (TN). Manipulation of PCTG can lead to significant hemodynamic changes, which may increase the risk of cardiovascular complications. However, to our knowledge, few studies have focused on anesthesia experience during PCTG as treatment for TN so far. It was our primary focus on how to ensure the stability of hemodynamics during our clinical anesthesia experience. This study aimed to compare the study group (using sodium nitroprusside [SNP] as soon as the puncture began) with the control group (without using SNP as soon as the puncture began) to investigate cardiovascular parameters (systolic blood pressure [SBP], diastolic blood pressure [DBP], and heart rate [HR]) at 5 periods during total intravenous anesthesia. ⋯ The control group and the study group were not able to prevent bradycardia elicited during PTCG. Compared with control group, dramatic elevations of the systemic blood pressure can be prevented using intravenous drip SNP as soon as the puncture began during total intravenous anesthesia in the study group. Our findings verify that intravenous drip SNP is an effective method to control abrupt rise of blood pressure.
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J Neurosurg Anesthesiol · Jan 2015
Comparative StudyComparison of Postoperative Volume Status and Hemodynamics Between Surgical Clipping and Endovascular Coiling in Patients After Subarachnoid Hemorrhage.
Recent clinical data suggest that postoperative hemodynamic profile and fluid management may differ in aneurysmal subarachnoid hemorrhage patients depending on the treatment option: surgical clipping or endovascular coiling. Our aim was to determine the differences in hemodynamic parameters between the 2 modalities using an advanced transpulmonary thermodilution technique. ⋯ Surgical clipping is associated with higher cardiac output and hypovolemia in the early postoperative stage and poorer preload responsiveness to volume therapy during the vasospasm risk period compared with endovascular coiling.