Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2020
Randomized Controlled TrialHigh-fidelity Training Model for Measurement of Dynamic Optic Nerve Sheath Diameter Using Transorbital Ultrasonography.
Transorbital ultrasonographic measurement of optic nerve sheath diameter (ONSD) is an important technique for bedside assessment of raised intracranial pressure (ICP). However, developing competency for this clinical skill requires practice scans on both normal subjects and patients with raised ICP. The aim of this study is to develop a high-fidelity training model capable of measuring dynamic changes in ONSD and to test the reliability and reproducibility of the model at different simulated ICP values. ⋯ We have developed a clinically relevant model capable of simulating changes in ONSD in patients with normal and raised ICP. This model could be a valuable training tool to gain scanning experience in optic nerve ultrasonography, and improve operators' technical abilities.
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J Neurosurg Anesthesiol · Jul 2020
Randomized Controlled Trial Comparative StudyIntubating Laryngeal Mask Airway-assisted Flexible Bronchoscopic Intubation is Associated With Reduced Cervical Spine Motion When Compared With C-MAC Video Laryngoscopy-guided Intubation: A Prospective Randomized Cross Over Trial.
In the evolving research into cervical spine mechanics during airway intervention, new devices are being constantly added to the armamentarium of anesthesiologists. In this study we compared cervical spine movement during orotracheal intubation using an intubating laryngeal mask airway (LMA Fastrach) assisted flexible bronchoscope or video laryngoscope. ⋯ There was significantly less movement in the craniocervical and upper cervical spine during LMA Fastrach assisted flexible bronchoscopic intubation compared to video laryngoscopic intubation.
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J Neurosurg Anesthesiol · Jul 2020
Pulse Pressure Variations and Plethysmographic Variability Index Measured at Ear are Able to Predict Fluid Responsiveness in the Sitting Position for Neurosurgery.
Pulse pressure variation (PPV) and plethysmographic variability index (PVI), dynamic indicators of preload dependence based on heart-lung interactions, are used to predict fluid responsiveness in mechanically ventilated patients in the supine position. The sitting position for neurosurgery, by changing intrathoracic blood volume, could affect the capacity of PPV and PVI to predict fluid responsiveness. The aim of the study was to assess the ability of PPV and PVI to predict fluid responsiveness during general anesthesia in the sitting position. ⋯ PPV can be used to predict fluid responsiveness in the sitting position for neurosurgery.
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J Neurosurg Anesthesiol · Jul 2020
Observational StudyImpact of Anesthesia on Long-term Outcomes in Patients With Supratentorial High-grade Glioma Undergoing Tumor Resection: A Retrospective Cohort Study.
Intravenous and inhalational anesthesia might have different associations with long-term outcome in cancer patients, with reports of adverse effects of inhalation anesthesia. However, the effects of anesthesia in patients with high-grade glioma (HGG) are not known. ⋯ Compared with maintenance of anesthesia with propofol, sevoflurane did not worsen progression-free or overall survival in patients with HGG undergoing tumor resection. However, propofol might be beneficial in patients with poor preoperative Karnofsky performance status.
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J Neurosurg Anesthesiol · Jul 2020
Hypotension and Hypocapnia During General Anesthesia in Piglets: Study of S100b as an Acute Biomarker for Cerebral Tissue Injury.
Hypotension and/or hypocapnia might increase general anesthesia (GA)-related neuromorbidity in infants, but safe levels of perioperative blood pressure are poorly defined. Serum protein S100b has been used as screening, monitoring, and prediction tool in the management of patients with traumatic brain injury. Using an animal model, we investigated serum S100b as an acute biomarker of cerebral hypoperfusion and cerebral cell dysfunction during hypotension, hypocapnia, or combined hypotension/hypocapnia during GA. ⋯ S100b did not increase following 60 minutes of systemic hypotension and/or hypocapnia during GA in piglets. In this setting, the use of S100b as a biomarker of cerebral cell tissue dysfunction cannot be supported.