Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Oct 2009
Randomized Controlled Trial Comparative StudyTracheal intubation with the PENTAX-AWS (airway scope) reduces changes of hemodynamic responses and bispectral index scores compared with the Macintosh laryngoscope.
The PENTAX-AWS, a novel video laryngoscope, allows indirect visualization of the vocal cords on a color monitor display and enables tracheal intubation without upward lifting force required to expose the glottis. This study compared hemodynamic changes, bispectral index scores, and postoperative sore throat before and after laryngoscopy between the Macintosh laryngoscope and the airway scope (AWS). Forty patients (American Society of Anesthesiologists I-II), randomly assigned to either the Macintosh group (n=20 each) or AWS group, were enrolled in this study. ⋯ Macintosh group). Postoperative sore throat was observed in both groups (2 out of 20 in AWS and 6 out of 20 in Macintosh), although this difference did not reach statistically significant level (P=0.23). In conclusion, the AWS offers a reduced degree of hemodynamic stimulation compared with the Macintosh laryngoscope, suggesting that tracheal intubation with the AWS is advantageous to prevent hypertension after laryngoscopy in neurosurgical patients.
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J Neurosurg Anesthesiol · Oct 2009
A retrospective cohort study of the association of anesthesia and hernia repair surgery with behavioral and developmental disorders in young children.
Recent animal studies have shown that commonly used anesthetic agents may have serious neurotoxic effects on the developing brain. The purpose of this study was to assess the association between surgery for hernia repair and the risk of behavioral and developmental disorders in young children. ⋯ After controlling for age, sex, and complicating birth-related conditions such as low birth weight, children who underwent hernia repair under 3 years of age were more than twice as likely as children in the comparison group to be subsequently diagnosed with a developmental or behavioral disorder (adjusted hazard ratio 2.3, 95% confidence interval 1.3, 4.1). Our findings add to recent evidence of the potential association of surgery and its concurrent exposure to anesthetic agents with neurotoxicity and underscore the need for more rigorous clinical research on the long-term effects of surgery and anesthesia in children.
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J Neurosurg Anesthesiol · Oct 2009
Cerebral hemodynamic changes in severe head injury patients undergoing decompressive craniectomy.
To assess the intracranial hemodynamic modifications induced by a decompressive craniectomy (DC) after severe traumatic brain injury (TBI), using transcranial Doppler (TCD) ultrasonography and intracranial pressure (ICP) sensor. Mortality rate and neurological outcomes were also evaluated after this procedure. ⋯ The DC results in a significant, immediate, and durable improvement of ICP associated with a normalization of cerebral blood flow velocities in most TBI patients with refractory intracranial hypertension.
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J Neurosurg Anesthesiol · Oct 2009
Editorial Comment Historical ArticleVictorian water pumps and anesthetic neurotoxicity.