Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2012
Letter Case ReportsBilateral Tapia syndrome secondary to oropharyngeal intubation.
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J Neurosurg Anesthesiol · Jan 2012
Long-term intrathecal drug administration for chronic nonmalignant pain.
Chronic pain of nonmalignant origin requires effective long-term treatments, as for many patients pain management will be necessary throughout the rest of their lives. Intrathecal drug delivery systems (IDDS) have become a recognized therapy for the management of severe and otherwise intractable chronic pain. However, it is still not clear whether this treatment can be effective for periods up to 10 years or longer, given the paucity of long-term follow-up. This study sought to examine the effectiveness of IDDS following an average of 13 years postimplantation. ⋯ This study, with one of the longest follow-up intervals reported in the IDDS literature, shows that IDDS has the potential to be a life-long pain management solution in appropriately selected patients with chronic nonmalignant pain.
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The electroencephalogram contains small electrical signals that are vulnerable to contamination from high-frequency noise during electrocautery. The bispectral index (BIS) monitor incorporated hardware and software changes to eliminate artifacts, thus allowing BIS monitoring even in the presence of electrocautery. We evaluated the accuracy of BIS to measure anesthetic effect during electrocautery interference. ⋯ Rejecting and filtering artifacts from electrocautery interference reduced the ability of BIS to respond to a change in anesthetic depth. BIS values during electrocautery should be interpreted with caution.
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J Neurosurg Anesthesiol · Jan 2012
Randomized Controlled Trial Comparative StudyThe effect of pressure-controlled ventilation on pulmonary mechanics in the prone position during posterior lumbar spine surgery: a comparison with volume-controlled ventilation.
When an anesthetized patient is turned to the prone position using the Wilson frame, dynamic compliance (Cdyn) decreases and peak airway pressure (Ppeak) increases. As pressure-controlled ventilation (PCV) decreases the Ppeak, this prospective, randomized study was designed to compare the effect of PCV and volume-controlled ventilation (VCV) on lung mechanics in the prone position using the Wilson frame during posterior lumbar spine surgery. ⋯ PCV provides lower Ppeak compared with VCV when the ventilator is set to deliver the same tidal volume and variable respiratory rate to maintain a constant end-tidal carbon dioxide tension in patients undergoing posterior lumbar spine surgery in the prone position using the Wilson frame.