Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Apr 2012
High-frequency stimulation restored motor-evoked potentials to the baseline level in the upper extremities but not in the lower extremities under sevoflurane anesthesia in spine surgery.
Volatile anesthetics attenuate medium-frequency (250 to 500 Hz) pulse train transcranial electrical stimulation (TES) motor-evoked potentials (MEPs) better than propofol. High-frequency (1000 Hz) TES may restore hand MEP amplitude under volatile anesthesia, but its effect on leg MEPs critical for spine surgery monitoring is unknown. ⋯ Sevoflurane is inadvisable for MEP monitoring in the legs during spine surgery as modulation of the TES frequency did not eliminate the suppressive effect of sevoflurane on the MEPs in the legs. Clinicians should be forewarned of the greater risk of unmonitorable MEPs, especially in the legs, under sevoflurane anesthesia.
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J Neurosurg Anesthesiol · Apr 2012
Randomized Controlled Trial Comparative StudyComparison between intraoperative fentanyl and tramadol to improve quality of emergence.
Cough causes poor quality of emergence from anesthesia and risks of several complications. We compared fentanyl and an antitussive action of tramadol on the quality of emergence and postoperative outcome. ⋯ A dose of 1 mg/kg of tramadol administered intravenously 30 minutes before the expected extubation, compared with 1 μg/kg of fentanyl, decreased cough incidence, improved emergence quality, and provided stable hemodynamics. However, there was no significant difference between tramadol and fentanyl in pain scores and fentanyl consumption postoperatively.
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J Neurosurg Anesthesiol · Apr 2012
Randomized Controlled TrialChanges in intraocular pressure during prone spine surgery under propofol and sevoflurane anesthesia.
Intraocular pressure (IOP) has been shown to increase during prone spine surgery. Although propofol and sevoflurane have been widely used during such surgery, there have been no data to compare the IOP changes under propofol and sevoflurane anesthesia. The present study was therefore conducted to investigate IOP changes under propofol and sevoflurane anesthesia during prone spine surgery. ⋯ The results indicated that the choice of anesthetic agent, sevoflurane or propofol, did not have significant effects on IOP changes during a relatively short interval of prone spine surgery.