Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2024
Factors Associated With Unplanned Post-Craniotomy Re-intubation in Children: A NSQIP-Pediatric® Analysis.
Most children undergoing craniotomy with general endotracheal anesthesia are extubated postoperatively, but some require unplanned postoperative intubation (UPI). We sought to determine the incidence of UPI and identify associated factors and related postoperative mortality. ⋯ Although uncommon, UPI in children who underwent craniotomy was associated with an elevated risk of postoperative mortality. The presence of identifiable risk factors may be used for preoperative counseling and risk profiling in these patients.
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J Neurosurg Anesthesiol · Jan 2024
Observational StudyEffect of Different Surgical Positions on the Changes in Cerebral Venous Drainage in Patients Undergoing Neurosurgery: A Prospective Observational Study.
Some patient positions employed to facilitate neurosurgery can compromise cerebral venous drainage and lead to increased intracranial pressure, intraoperative bleeding, and brain bulge. This study evaluated the impact of different surgical positions on internal jugular vein (IJV) flow as a measure of cerebral venous drainage and on optic nerve sheath diameter (ONSD) as an indirect assessment of intracranial pressure. ⋯ Mean IJV flow decreased from baseline following the final neurosurgical positioning. Ultrasound-guided assessment of IJV flow could be a useful tool to quantify position-related changes in IJV drainage.
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J Neurosurg Anesthesiol · Jan 2024
Simulation in Anesthesia for Perioperative Neuroscience: Present and Future.
The brain's sensitivity to fluctuations in physiological parameters demands precise control of anesthesia during neurosurgery, which, combined with the complex nature of neurosurgical procedures and potential for adverse outcomes, makes neuroanesthesia challenging. Neuroanesthesiologists, as perioperative physicians, work closely with neurosurgeons, neurologists, neurointensivists, and neuroradiologists to provide care for patients with complex neurological diseases, often dealing with life-threatening conditions such as traumatic brain injuries, brain tumors, cerebral aneurysms, and spinal cord injuries. ⋯ Simulation models, including high-fidelity manikins, virtual reality, and computer-based simulations, can replicate physiological responses, anatomical structures, and complications associated with neurosurgical procedures. The use of high-fidelity simulation can act as a valuable complement to real-life clinical exposure and training in neuroanesthesia.