Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Apr 2013
Comparative StudyAn observational study of the influence of "white-coat hypertension" on day-of-surgery blood pressure determinations.
Because decisions as to what range of intraoperative blood pressure (BP) is consistent with cerebral well-being are often made in reference to "baseline BP," we sought to determine whether day-of-surgery BPs accurately reflect baseline BP, as defined by ambulatory clinic BPs over the preceding 7 months. ⋯ For most patients whose 1st OR-BP is hypertensive, that BP is greater than ambulatory clinic BPs recorded during the preceding 7 months. For most patients with Severe-HTN at 1st OR-BP, day-of-surgery BPs overestimate Baseline-BP and reference to prehospitalization BPs is advisable. When 1st OR-BP is normotensive, that BP usually reflects Baseline-BP.
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J Neurosurg Anesthesiol · Apr 2013
Comparative StudyAn alternative position for the BIS-Vista montage in frontal approach neurosurgical cases.
Appropriate placement of the bispectral index (BIS)-vista montage for frontal approach neurosurgical procedures is a neuromonitoring challenge. The standard bifrontal application interferes with the operative field; yet to date, no other placements have demonstrated good agreement. The purpose of our study was to compare the standard BIS montage with an alternate BIS montage across the nasal dorsum for neuromonitoring. ⋯ We determined that the nasal montage produces values that have slightly more variability compared with that ideally desired, but the variability is not clinically significant. In cases where the standard BIS-vista montage would interfere with the operative field, an alternative positioning of the BIS montage across the nasal bridge and under the eye can be used.
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J Neurosurg Anesthesiol · Apr 2013
Letter Case ReportsCervical spinal cord AVM rupture in parturient.