Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Apr 2012
Randomized Controlled TrialPerioperative pregabalin for postoperative pain control and quality of life after major spinal surgery.
Adequate management of postoperative pain after major spine surgery is often difficult to achieve. We investigated the efficacy of an antineuropathic pain drug, pregabalin (PG), on postoperative pain control and on improvement of quality of life (QoL). ⋯ Perioperative PG administration reduces early postsurgical pain at rest and particularly during movement after major spine surgery with less opioid consumption, and it seems to influence the improvement of overall QoL 3 months after surgery.
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J Neurosurg Anesthesiol · Apr 2012
Randomized Controlled Trial Comparative StudyThiopental-induced burst suppression measured by the bispectral index is extended during propofol administration compared with sevoflurane.
Thiopental is used to suppress cerebral metabolism during temporary clip ligation of the cerebral arteries. Electroencephalogram (EEG) can measure intraoperative burst suppression as evidence of cerebral metabolic suppression, but EEG is not always available during clip ligation. This study was conducted to compare the effect of propofol-based total intravenous anesthesia (TIVA) with sevoflurane-based inhalational anesthesia on thiopental-induced burst suppression during aneurysm surgery. The effect of thiopental was measured by burst suppression ratio (BSR) using the bispectral index (BIS) monitor. ⋯ Our results suggest that at equivalent BIS values TIVA with propofol anesthesia provides longer duration and greater cerebral metabolic suppression compared with sevoflurane-N(2)O inhalation anesthesia. BIS may be an acceptable alternative to standard EEG monitoring when assessing burst suppression during temporary clipping.
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With a focus on landmark investigations, common themes, and unique and innovative contributions to the literature, we provide a synopsis of the 2011 literature pertaining to general advances in neurosurgical procedures and perioperative care and anesthetic management of neurosurgical patients.