Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 1997
Randomized Controlled Trial Comparative Study Clinical TrialPatient-controlled sedation using propofol during interventional neuroradiologic procedures.
Patient-controlled sedation (PCS) using propofol has been reported to provide safe and effective sedation during a variety of procedures performed under regional or local anesthesia. In a prospective, randomized fashion, this study evaluated propofol PCS compared to anesthesiologist-administered midazolam-fentanyl sedation during interventional neuroradiologic (INR) procedures. Nineteen patients undergoing 24 INR procedures received propofol PCS (PCS dose, 0.5 mg/kg; lockout interval, 3 min) or anesthesiologist-administered midazolam-fentanyl sedation. ⋯ These included ventilatory depression (two patients in each group) and excessive sedation (two patients in each group). Three patients in the propofol group became excessively restless, resulting in brief interruptions during the respective procedures. Propofol PCS offers a safe sedation technique during INR procedures with a sedation and anxiolysis profile that was not distinguishable from anesthesiologist-administered midazolam-fentanyl sedation.
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J Neurosurg Anesthesiol · Oct 1996
Randomized Controlled Trial Clinical TrialEffects of perioperative indomethacin on intracranial pressure, cerebral blood flow, and cerebral metabolism in patients subjected to craniotomy for cerebral tumors.
This study was carried out to evaluate the effects of perioperative indomethacin on intracranial pressure (ICP), cerebral blood flow (CBF), and cerebral metabolism. Twenty patients subjected to craniotomy for supratentorial cerebral tumors were anesthetized with thiopental, fentanyl, nitrous oxide, and isoflurane. A PaCO2 level averaging 4.8 kPa (median) was achieved. ⋯ In one patient, mannitol treatment was necessary to prevent dural tightness. In the placebo group, mannitol supplemented with hypocapnia was applied in five patients. These findings suggest that perioperative treatment with indomethacin is an excellent treatment of intracranial hypertension during normocapnic isoflurane anesthesia for craniotomy.
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J Neurosurg Anesthesiol · Apr 1995
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of anesthetic techniques for awake intubation in neurosurgical patients.
Two different methods of achieving upper airway anesthesia for awake fiberoptic intubation were prospectively compared in patients undergoing surgery for cervical spine instability. Forty patients were randomized to either topical anesthesia or nerve block groups. Topical anesthesia patients were administered nebulized 4% lidocaine (approximately 20 ml) via the oropharynx plus a transtracheal injection of 4% lidocaine (3 ml). ⋯ Ten minutes later there was no difference for plasma lidocaine concentration between groups. No patients had evidence of seizures or neurologic change during the procedure. There was no difference in patient perception of discomfort during the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)
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J Neurosurg Anesthesiol · Jul 1993
Randomized Controlled Trial Clinical TrialClonidine premedication for craniotomy: effects on blood pressure and thiopentone dosage.
The purpose of this study was to determine whether oral clonidine premedication improves cardiovascular stability and/or reduces the requirements for drugs used to control systolic blood pressure (SBP) during elective craniotomies. We performed a double blind randomized trial involving 77 normotensive, ASA physical status I or II adults. Clonidine 4 micrograms/kg or placebo was given as oral premedication. ⋯ Two subgroups were analyzed, based on the study groups mean age and baseline SBP. Three-way analysis of variance revealed that the blood pressure effects of clonidine were almost entirely confined to patients older than 45 years. Baseline SBP had no independent effect.(ABSTRACT TRUNCATED AT 250 WORDS)