Journal of neurosurgical anesthesiology
-
J Neurosurg Anesthesiol · Apr 2013
Randomized Controlled TrialEfficacy and safety of local versus general anesthesia in stereotactic biopsies: a matched-pairs cohort study.
Frame-based stereotactic biopsies remain the gold standard for the diagnosis of intracerebral lesions. A major advantage is the ability to perform these procedures under local anesthesia (LA). However, there is no consensus on whether or when to use LA or general anesthesia (GA). It has been postulated that the use of LA may reduce the risk of complications. This study aims to objectify the efficacy and safety of stereotactic biopsies under LA versus GA by analyzing a prospective registry for stereotactic biopsies. ⋯ The type of anesthesia may not interfere with the diagnostic yield in stereotactic biopsies. Patients operated under LA are less likely to suffer pulmonary complications. Furthermore, LA could spare hospital resources in this setting.
-
J Neurosurg Anesthesiol · Apr 2013
Randomized Controlled TrialEfficacy of intravenous paracetamol and dexketoprofen on postoperative pain and morphine consumption after a lumbar disk surgery.
We compared the analgesic effects of intravenous (IV) paracetamol with that of dexketoprofen on postoperative pain and morphine consumption during the first 24 hour after a lumbar disk surgery. ⋯ The study showed that pain intensity during 24 hours after the lumbar disk surgery was significantly lowered by dexketoprofen, but not with paracetamol, as a supplemental analgesic to morphine patient-controlled analgesia when compared with controls.
-
J Neurosurg Anesthesiol · Jan 2013
Randomized Controlled TrialThe effect of intraoperative infusion of dexmedetomidine on the quality of recovery after major spinal surgery.
Surgery induces a variety of metabolic, endocrine, and immune changes collectively known as the "stress response," which may often lead to prolonged postoperative convalescence. Anesthetic management may modulate this physiological response, thus affecting the postoperative course. We hypothesized that the intraoperative administration of dexmedetomidine (DEX), a sympatholytic agent, would reduce the stress response and improve the quality of recovery in patients undergoing major surgery. ⋯ DEX infusion during multilevel spinal fusions moderately improved the quality of recovery and possibly reduced fatigue in the early postoperative period. Moreover, it reduced plasma levels of cortisol and IL-10 in comparison with the control group. Our sample size was not sufficient to detect differences either in the incidence of complications or in clinically relevant outcomes.
-
J Neurosurg Anesthesiol · Jan 2013
Randomized Controlled TrialBIS-guided anesthesia decreases postoperative delirium and cognitive decline.
BIS use in elderly patients targeting a BIS of 40-60 may reduce post-operative delirium and post-operative cognitive decline at 3 months.
pearl -
J Neurosurg Anesthesiol · Jan 2013
Randomized Controlled TrialThe effect of furosemide on intravascular volume status and electrolytes in patients receiving mannitol: an intraoperative safety analysis.
Mannitol is often used during intracranial surgery to improve surgical exposure. Furosemide is often added to mannitol to augment this effect. The concern exists, however, that the augmented diuresis caused by the addition of furosemide to mannitol may cause hypovolemia and hypoperfusion, hypokalemia, and hyponatremia. We examined the intraoperative safety of low-dose furosemide (0.3 mg/kg) combined with mannitol (1 g/kg). ⋯ Despite an increase in urine output by as much as 67%, adding low-dose furosemide to mannitol does not seem to produce significant electrolyte derangements or hypovolemia compared with the administration of mannitol alone.